地中海饮食、其组成成分与心血管疾病。

The Mediterranean diet, its components, and cardiovascular disease.

作者信息

Widmer R Jay, Flammer Andreas J, Lerman Lilach O, Lerman Amir

机构信息

Division of Cardiovascular Diseases, Mayo School of Graduate Medical Education, Rochester, Minn.

Division of Nephrology and Hypertension, Mayo School of Graduate Medical Education, Rochester, Minn.

出版信息

Am J Med. 2015 Mar;128(3):229-38. doi: 10.1016/j.amjmed.2014.10.014. Epub 2014 Oct 15.

Abstract

One of the best-studied diets for cardiovascular health is the Mediterranean diet. This consists of fish, monounsaturated fats from olive oil, fruits, vegetables, whole grains, legumes/nuts, and moderate alcohol consumption. The Mediterranean diet has been shown to reduce the burden, or even prevent the development, of cardiovascular disease, breast cancer, depression, colorectal cancer, diabetes, obesity, asthma, erectile dysfunction, and cognitive decline. This diet is also known to improve surrogates of cardiovascular disease, such as waist-to-hip ratio, lipids, and markers of inflammation, as well as primary cardiovascular disease outcomes such as death and events in both observational and randomized controlled trial data. These enhancements easily rival those seen with more established tools used to fight cardiovascular disease such as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and exercise. However, it is unclear if the Mediterranean diet offers cardiovascular disease benefit from its individual constituents or in aggregate. Furthermore, the potential benefit of the Mediterranean diet or its components is not yet validated by concrete cardiovascular disease endpoints in randomized trials or observational studies. This review will focus on the effects of the whole and parts of the Mediterranean diet with regard to both population-based and experimental data highlighting cardiovascular disease morbidity or mortality and cardiovascular disease surrogates when hard outcomes are not available. Our synthesis will highlight the potential for the Mediterranean diet to act as a key player in cardiovascular disease prevention, and attempt to identify certain aspects of the diet that are particularly beneficial for cardioprotection.

摘要

对心血管健康研究最多的饮食之一是地中海饮食。它包括鱼类、橄榄油中的单不饱和脂肪、水果、蔬菜、全谷物、豆类/坚果,以及适量饮酒。地中海饮食已被证明可以减轻心血管疾病、乳腺癌、抑郁症、结肠直肠癌、糖尿病、肥胖症、哮喘、勃起功能障碍和认知衰退的负担,甚至预防其发生。在观察性和随机对照试验数据中,这种饮食还能改善心血管疾病的替代指标,如腰臀比、血脂和炎症标志物,以及主要的心血管疾病结局,如死亡和发病情况。这些改善效果与用于对抗心血管疾病的更成熟手段(如阿司匹林、β受体阻滞剂、血管紧张素转换酶抑制剂和运动)所带来的效果不相上下。然而,尚不清楚地中海饮食是因其单个成分还是整体组合而对心血管疾病有益。此外,地中海饮食或其成分的潜在益处尚未在随机试验或观察性研究中通过具体的心血管疾病终点得到验证。本综述将重点关注地中海饮食整体及其各部分对基于人群的数据和实验数据的影响,在缺乏硬终点数据时,突出心血管疾病的发病率或死亡率以及心血管疾病替代指标。我们的综合分析将突出地中海饮食在心血管疾病预防中发挥关键作用的潜力,并试图确定该饮食中对心脏保护特别有益的某些方面。

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