Hooper Lee, Kroon Paul A, Rimm Eric B, Cohn Jeffrey S, Harvey Ian, Le Cornu Kathryn A, Ryder Jonathan J, Hall Wendy L, Cassidy Aedín
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom.
Am J Clin Nutr. 2008 Jul;88(1):38-50. doi: 10.1093/ajcn/88.1.38.
The beneficial effects of flavonoid consumption on cardiovascular risk are supported by mechanistic and epidemiologic evidence.
We aimed to systematically review the effectiveness of different flavonoid subclasses and flavonoid-rich food sources on cardiovascular disease (CVD) and risk factors--ie, lipoproteins, blood pressure, and flow-mediated dilatation (FMD).
Methods included a structured search strategy on MEDLINE, EMBASE, and Cochrane databases; formal inclusion or exclusion, data extraction, and validity assessment; and meta-analysis.
One hundred thirty-three trials were included. No randomized controlled trial studied effects on CVD morbidity or mortality. Significant heterogeneity confirmed differential effects between flavonoid subclasses and foods. Chocolate increased FMD after acute (3.99%; 95% CI: 2.86, 5.12; 6 studies) and chronic (1.45%; 0.62, 2.28; 2 studies) intake and reduced systolic (-5.88 mm Hg; -9.55, -2.21; 5 studies) and diastolic (-3.30 mm Hg; -5.77, -0.83; 4 studies) blood pressure. Soy protein isolate (but not other soy products or components) significantly reduced diastolic blood pressure (-1.99 mm Hg; -2.86, -1.12; 9 studies) and LDL cholesterol (-0.19 mmol/L; -0.24, -0.14; 39 studies). Acute black tea consumption increased systolic (5.69 mm Hg; 1.52, 9.86; 4 studies) and diastolic (2.56 mm Hg; 1.03, 4.10; 4 studies) blood pressure. Green tea reduced LDL (-0.23 mmol/L; -0.34, -0.12; 4 studies). For many of the other flavonoids, there was insufficient evidence to draw conclusions about efficacy.
To date, the effects of flavonoids from soy and cocoa have been the main focus of attention. Future studies should focus on other commonly consumed subclasses (eg, anthocyanins and flavanones), examine dose-response effects, and be of long enough duration to allow assessment of clinically relevant endpoints.
类黄酮摄入对心血管风险的有益影响得到了机制和流行病学证据的支持。
我们旨在系统评价不同类黄酮亚类和富含类黄酮的食物来源对心血管疾病（CVD）及其危险因素——即脂蛋白、血压和血流介导的血管舒张（FMD）的有效性。
方法包括对MEDLINE、EMBASE和Cochrane数据库进行结构化检索策略；正式纳入或排除、数据提取和有效性评估；以及荟萃分析。
共纳入133项试验。没有随机对照试验研究对CVD发病率或死亡率的影响。显著的异质性证实了类黄酮亚类和食物之间的不同作用。急性（3.99%；95%CI：2.86，5.12；6项研究）和慢性（1.45%；0.62，2.28；2项研究）摄入巧克力后可增加FMD，并降低收缩压（-5.88mmHg；-9.55，-2.21；5项研究）和舒张压（-3.30mmHg；-5.77，-0.83；4项研究）。大豆分离蛋白（而非其他大豆制品或成分）可显著降低舒张压（-1.99mmHg；-2.86，-1.12；9项研究）和低密度脂蛋白胆固醇（-0.19mmol/L；-0.24，-0.14；39项研究）。急性饮用红茶可升高收缩压（5.69mmHg；1.52，9.86；4项研究）和舒张压（2.56mmHg；l.03，4.10；4项研究）。绿茶可降低低密度脂蛋白（-0.23mmol/L；-0.34，-0.12；4项研究）。对于许多其他类黄酮，尚无足够证据得出关于疗效的结论。
迄今为止，大豆和可可中的类黄酮的作用一直是关注的焦点。未来的研究应关注其他常见的亚类（如花色苷和黄烷酮），研究剂量反应效应，并且持续时间应足够长，以便能够评估临床相关终点。
