坚果摄入与血脂水平：25项干预试验的汇总分析

Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials.

作者信息

Sabaté Joan, Oda Keiji, Ros Emilio

机构信息

Department of Nutrition, Loma Linda University, Nichol Hall Room 1102, Loma Linda, CA 92350, USA.

出版信息

Arch Intern Med. 2010 May 10;170(9):821-7. doi: 10.1001/archinternmed.2010.79.

DOI:10.1001/archinternmed.2010.79

PMID:20458092

Abstract

BACKGROUND

Epidemiological studies have consistently associated nut consumption with reduced risk for coronary heart disease. Subsequently, many dietary intervention trials investigated the effects of nut consumption on blood lipid levels. The objectives of this study were to estimate the effects of nut consumption on blood lipid levels and to examine whether different factors modify the effects.

METHODS

We pooled individual primary data from 25 nut consumption trials conducted in 7 countries among 583 men and women with normolipidemia and hypercholesterolemia who were not taking lipid-lowering medications. In a pooled analysis, we used mixed linear models to assess the effects of nut consumption and the potential interactions.

RESULTS

With a mean daily consumption of 67 g of nuts, the following estimated mean reductions were achieved: total cholesterol concentration (10.9 mg/dL [5.1% change]), low-density lipoprotein cholesterol concentration (LDL-C) (10.2 mg/dL [7.4% change]), ratio of LDL-C to high-density lipoprotein cholesterol concentration (HDL-C) (0.22 [8.3% change]), and ratio of total cholesterol concentration to HDL-C (0.24 [5.6% change]) (P < .001 for all) (to convert all cholesterol concentrations to millimoles per liter, multiply by 0.0259). Triglyceride levels were reduced by 20.6 mg/dL (10.2%) in subjects with blood triglyceride levels of at least 150 mg/dL (P < .05) but not in those with lower levels (to convert triglyceride level to millimoles per liter, multiply by 0.0113). The effects of nut consumption were dose related, and different types of nuts had similar effects on blood lipid levels. The effects of nut consumption were significantly modified by LDL-C, body mass index, and diet type: the lipid-lowering effects of nut consumption were greatest among subjects with high baseline LDL-C and with low body mass index and among those consuming Western diets.

CONCLUSION

Nut consumption improves blood lipid levels in a dose-related manner, particularly among subjects with higher LDL-C or with lower BMI.

摘要

背景

流行病学研究一直表明，食用坚果与降低冠心病风险相关。随后，许多饮食干预试验研究了食用坚果对血脂水平的影响。本研究的目的是评估食用坚果对血脂水平的影响，并探讨不同因素是否会改变这些影响。

方法

我们汇总了在7个国家进行的25项坚果食用试验的个体原始数据，这些试验涉及583名未服用降脂药物的血脂正常和高胆固醇血症的男性和女性。在汇总分析中，我们使用混合线性模型来评估食用坚果的影响以及潜在的相互作用。

结果

平均每日食用67克坚果时，实现了以下估计的平均降低：总胆固醇浓度（10.9毫克/分升[变化5.1%]）、低密度脂蛋白胆固醇浓度（LDL-C）（10.2毫克/分升[变化7.4%]）、LDL-C与高密度脂蛋白胆固醇浓度（HDL-C）的比值（0.22[变化8.3%]）以及总胆固醇浓度与HDL-C的比值（0.24[变化5.6%]）（所有P均<0.001）（要将所有胆固醇浓度转换为毫摩尔/升，乘以0.0259）。甘油三酯水平在血液甘油三酯水平至少为150毫克/分升的受试者中降低了20.6毫克/分升（10.2%）（P<0.05），但在水平较低的受试者中未降低（要将甘油三酯水平转换为毫摩尔/升，乘以0.0113）。食用坚果的影响与剂量相关，不同类型的坚果对血脂水平有相似的影响。食用坚果的影响受到LDL-C、体重指数和饮食类型的显著影响：食用坚果的降脂作用在基线LDL-C高、体重指数低的受试者以及食用西方饮食的受试者中最为明显。