地中海式饮食对心血管危险因素的影响：一项随机试验。

Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial.

作者信息

Estruch Ramon, Martínez-González Miguel Angel, Corella Dolores, Salas-Salvadó Jordi, Ruiz-Gutiérrez Valentina, Covas María Isabel, Fiol Miguel, Gómez-Gracia Enrique, López-Sabater Mari Carmen, Vinyoles Ernest, Arós Fernando, Conde Manuel, Lahoz Carlos, Lapetra José, Sáez Guillermo, Ros Emilio

机构信息

Institut d'Investigacions Biomèdiques August Pi Sunyer, Municipal Institut for Medical Research, University of Barcelona, and Catalan Institute of Health, Barcelona, Spain.

出版信息

Ann Intern Med. 2006 Jul 4;145(1):1-11. doi: 10.7326/0003-4819-145-1-200607040-00004.

DOI:10.7326/0003-4819-145-1-200607040-00004

PMID:16818923

Abstract

BACKGROUND

The Mediterranean diet has been shown to have beneficial effects on cardiovascular risk factors.

OBJECTIVE

To compare the short-term effects of 2 Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk.

DESIGN

Substudy of a multicenter, randomized, primary prevention trial of cardiovascular disease (Prevención con Dieta Mediterránea [PREDIMED] Study).

SETTING

Primary care centers affiliated with 10 teaching hospitals.

PARTICIPANTS

772 asymptomatic persons 55 to 80 years of age at high cardiovascular risk who were recruited from October 2003 to March 2004.

INTERVENTIONS

Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months.

MEASUREMENTS

Body weight, blood pressure, lipid profile, glucose levels, and inflammatory molecules.

RESULTS

The completion rate was 99.6%. Compared with the low-fat diet, the 2 Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were -0.39 mmol/L (95% CI, -0.70 to -0.07 mmol/L) and -0.30 mmol/L (CI, -0.58 to -0.01 mmol/L), respectively, for plasma glucose levels; -5.9 mm Hg (CI, -8.7 to -3.1 mm Hg) and -7.1 mm Hg (CI, -10.0 to -4.1 mm Hg), respectively, for systolic blood pressure; and -0.38 (CI, -0.55 to -0.22) and - 0.26 (CI, -0.42 to -0.10), respectively, for the cholesterol-high-density lipoprotein cholesterol ratio. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet.

LIMITATIONS

This short-term study did not focus on clinical outcomes. Nutritional education about low-fat diet was less intense than education about Mediterranean diets.

CONCLUSION

Compared with a low-fat diet, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.

摘要

背景

地中海饮食已被证明对心血管危险因素具有有益影响。

目的

比较两种地中海饮食与低脂饮食对心血管风险中间标志物的短期影响。

设计

一项多中心、随机、心血管疾病一级预防试验（地中海饮食预防[PREDIMED]研究）的子研究。

地点

隶属于10家教学医院的基层医疗中心。

参与者

2003年10月至2004年3月招募的772名55至80岁、心血管风险高的无症状者。

干预措施

参与者被分配到低脂饮食组（n = 257）或两种地中海饮食组中的一组。分配到地中海饮食组的人接受营养教育，并分别获得免费的初榨橄榄油，每周1升（n = 257），或免费的坚果，每天30克（n = 258）。作者评估了3个月时的结果变化。

测量指标

体重、血压、血脂谱、血糖水平和炎症分子。

结果

完成率为99.6%。与低脂饮食相比，两种地中海饮食在大多数结果上产生了有益变化。与低脂饮食相比，橄榄油地中海饮食组和坚果地中海饮食组的血浆葡萄糖水平平均变化分别为-0.39 mmol/L（95%CI，-0.70至-0.07 mmol/L）和-0.30 mmol/L（CI，-0.58至-0.01 mmol/L）；收缩压分别为-5.9 mmHg（CI，-8.7至-3.1 mmHg）和-7.1 mmHg（CI，-10.0至-4.1 mmHg）；胆固醇与高密度脂蛋白胆固醇比值分别为-0.38（CI，-0.55至-0.22）和-0.26（CI，-0.42至-0.10）。与低脂饮食相比，橄榄油地中海饮食使C反应蛋白水平降低了0.54 mg/L（CI，1.04至0.03 mg/L）。