Mirmiran Parvin, Noori Nazanin, Zavareh Maryam Beheshti, Azizi Fereidoun
Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M.C.), PO Box: 19395-4763 Tehran, Iran.
Metabolism. 2009 Apr;58(4):460-8. doi: 10.1016/j.metabol.2008.11.002.
The international guidelines issued by the World Health Organization recommend reduction in dietary saturated fat and cholesterol intakes as means to prevent hypercholesterolemia and cardiovascular disease (CVD); however, only limited data are available on the benefits of fruit and vegetable consumption on CVD risk factors in a community-based population. The aim of this study was to examine whether, and to what extent, intake of fruits and vegetables is inversely associated with CVD risk factors in adults. In this population-based cross-sectional study, a representative sample of 840 Tehranian adults (male and female) aged 18 to 74 years was randomly selected in 1998. Multivariate logistic regression adjusted for lifestyle and nutritional confounders was used in 2 models. After adjusting for confounders, dietary fruit and vegetable were found to be significantly and inversely associated with CVD risk factors. Adjusted odds ratio for high low-density lipoprotein concentrations were 1.00, 0.88, 0.81, and 0.75 (P for trend < .01) in the first model, which was adjusted for age, sex, keys score, body mass index, energy intake, smoking status, dietary cholesterol, and history of diabetes mellitus and coronary artery disease, a trend which was not appreciably altered by additional adjustment for education, physical activity, and saturated, polyunsaturated, and total fat intakes. This association was observed across categories of smoking status, physical activity, and tertiles of the Keys score. Exclusion of subjects with prevalent diabetes mellitus or coronary artery disease did not alter these results significantly. Consumption of fruits and vegetables is associated with lower concentrations of total and low-density lipoprotein cholesterol and with the risk of CVD per se in a dose-response manner.
世界卫生组织发布的国际指南建议减少膳食中饱和脂肪和胆固醇的摄入量,以此作为预防高胆固醇血症和心血管疾病(CVD)的手段;然而,关于社区人群食用水果和蔬菜对心血管疾病风险因素的益处,仅有有限的数据。本研究的目的是检验成年人摄入水果和蔬菜是否以及在多大程度上与心血管疾病风险因素呈负相关。在这项基于人群的横断面研究中,1998年随机选取了840名年龄在18至74岁的德黑兰成年人(男性和女性)作为代表性样本。在两个模型中使用了针对生活方式和营养混杂因素进行调整的多变量逻辑回归。在对混杂因素进行调整后,发现膳食中的水果和蔬菜与心血管疾病风险因素显著负相关。在第一个模型中,针对年龄、性别、基斯评分、体重指数、能量摄入、吸烟状况、膳食胆固醇以及糖尿病和冠状动脉疾病史进行调整后,高低密度脂蛋白浓度的调整比值比分别为1.00、0.88、0.81和0.75(趋势P <.01),在对教育程度、身体活动以及饱和脂肪、多不饱和脂肪和总脂肪摄入量进行额外调整后,这一趋势并未明显改变。这种关联在吸烟状况、身体活动以及基斯评分三分位数的各个类别中均有观察到。排除患有糖尿病或冠状动脉疾病的受试者后,这些结果并未显著改变。水果和蔬菜的消费与总胆固醇和低密度脂蛋白胆固醇浓度较低以及心血管疾病本身的风险呈剂量反应关系。