Swain J F, Rouse I L, Curley C B, Sacks F M
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
N Engl J Med. 1990 Jan 18;322(3):147-52. doi: 10.1056/NEJM199001183220302.
Previous studies have shown that supplementation of the diet with oat bran may lower serum cholesterol levels. However, it is not known whether oat-bran diets lower serum cholesterol levels by replacing fatty foods in the diet or by a direct effect of the dietary fiber contained in oat bran. To determine which is the case, we compared the effect of isocaloric supplements of high-fiber oat bran (87 g per day) and a low-fiber refined-wheat product on the serum lipoprotein cholesterol levels of 20 healthy subjects, 23 to 49 years old. After a one-week base-line period during which they consumed their usual diets, the subjects were given each type of supplement for six-week periods in a double-blind, crossover trial. Mean serum cholesterol levels (+/- SD) were not significantly different during the high-fiber and low-fiber periods: total cholesterol, 4.44 +/- 0.73 and 4.46 +/- 0.64 mmol per liter (172 +/- 28 and 172 +/- 25 mg per deciliter); low-density lipoprotein, 2.69 +/- 0.63 and 2.77 +/- 0.59 mmol per liter (104 +/- 24 and 107 +/- 23 mg per deciliter); and high-density lipoprotein, 1.40 +/- 0.39 and 1.32 +/- 0.39 mmol per liter (54.2 +/- 15.0 and 50.9 +/- 15.2 mg per deciliter), respectively. However, both types of supplements lowered the mean base-line serum cholesterol level, 4.80 +/- 0.80 mmol per liter (186 +/- 31 mg per deciliter), by 7 to 8 percent (95 percent confidence interval for high fiber, 11 to 4 percent, and for low fiber, 11 to 3 percent). The subjects ate less saturated fat and cholesterol and more polyunsaturated fat during both periods of supplementation than at base line. Those changes in dietary fats were sufficient to explain all of the reduction in serum cholesterol levels caused by the high-fiber and low-fiber diets. The average blood pressure was 112/68 mm Hg at base line and did not change during either dietary period. We conclude that oat bran has little cholesterol-lowering effect and that high-fiber and low-fiber dietary grain supplements reduce serum cholesterol levels about equally, probably because they replace dietary fats.
先前的研究表明,在饮食中添加燕麦麸可能会降低血清胆固醇水平。然而,尚不清楚燕麦麸饮食是通过替代饮食中的脂肪类食物还是通过燕麦麸中膳食纤维的直接作用来降低血清胆固醇水平。为了确定是哪种情况,我们比较了高热量的高纤维燕麦麸(每天87克)补充剂和低纤维精制小麦产品对20名年龄在23至49岁的健康受试者血清脂蛋白胆固醇水平的影响。在为期一周的基线期内,受试者食用他们平常的饮食,之后在一项双盲交叉试验中,让受试者分别服用每种补充剂六周。在高纤维期和低纤维期,平均血清胆固醇水平(±标准差)无显著差异:总胆固醇分别为4.44±0.73和4.46±0.64毫摩尔/升(172±28和172±25毫克/分升);低密度脂蛋白分别为2.69±0.63和2.77±0.59毫摩尔/升(104±24和107±23毫克/分升);高密度脂蛋白分别为1.40±0.39和1.32±0.39毫摩尔/升(54.2±15.0和50.9±15.2毫克/分升)。然而,两种补充剂都使平均基线血清胆固醇水平从4.80±0.80毫摩尔/升(186±31毫克/分升)降低了7%至8%(高纤维的95%置信区间为11%至4%,低纤维的为11%至3%)。在两个补充期内,受试者摄入的饱和脂肪和胆固醇比基线期少,而多不饱和脂肪比基线期多。饮食中脂肪的这些变化足以解释高纤维和低纤维饮食导致的血清胆固醇水平的所有降低。基线时平均血压为112/68毫米汞柱,在任何一个饮食期内均未改变。我们得出结论,燕麦麸降低胆固醇的作用很小,高纤维和低纤维的谷物补充剂降低血清胆固醇水平的效果大致相同,可能是因为它们替代了饮食中的脂肪。