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成人膳食中链甘油三酯与长链甘油三酯对身体成分的影响:随机对照试验的系统评价和荟萃分析

Dietary medium-chain triacylglycerols versus long-chain triacylglycerols for body composition in adults: systematic review and meta-analysis of randomized controlled trials.

作者信息

Bueno Nassib B, de Melo Ingrid V, Florêncio Telma T, Sawaya Ana L

机构信息

a Laboratório de Fisiologia da Nutrição, Departamento de Nutrição, Universidade Federal de São Paulo , Sao Paulo , BRASIL.

出版信息

J Am Coll Nutr. 2015;34(2):175-83. doi: 10.1080/07315724.2013.879844. Epub 2015 Feb 4.

Abstract

OBJECTIVE

To assess the effect of replacing dietary long-chain triacylglycerols (LCTs) with medium-chain triacylglycerols (MCTs) on body composition in adults.

METHODS

We conducted a meta-analysis of randomized controlled trials (RCTs), to determine whether individuals assigned to replace at least 5 g of dietary LCTs with MCTs for a minimum of 4 weeks show positive modifications on body composition. We systematically searched, through July 2013, the CENTRAL, EMBASE, LILACS, and MEDLINE databases for RCTs that investigated the effects of MCT intake on body composition in adults. Two authors independently extracted data and assessed risk of bias. Weighted mean differences (WMDs) were calculated for net changes in the outcomes. We assessed heterogeneity by the Cochran Q test and I(2) statistic and publication bias with the Egger's test. Prespecified sensitivity analyses were performed.

RESULTS

In total, 11 trials were included, from which 5 presented low risk of bias. In the overall analysis, including all studies, individuals who replaced dietary LCT with MCT showed significantly reduced body weight (WMD, -0.69 kg; 95% confidence interval [CI], -1.1 to -0.28; p = 0.001); body fat (-0.89 kg; 95% CI, -1.27 to -0.51; p < 0.001), and WC (-1.78 cm; 95% CI, -2.4 to -1.1; p < 0.001). The overall quality of the evidence was low to moderate. Trials with a crossover design were responsible for the heterogeneity.

CONCLUSION

Despite statistically significant results, the recommendation to replace dietary LCTs with MCTs must be cautiously taken, because the available evidence is not of the highest quality.

摘要

目的

评估用中链甘油三酯(MCTs)替代膳食长链甘油三酯(LCTs)对成年人身体成分的影响。

方法

我们对随机对照试验(RCTs)进行了荟萃分析,以确定被分配用MCTs替代至少5克膳食LCTs至少4周的个体在身体成分方面是否有积极改善。我们通过2013年7月,系统检索了Cochrane系统评价、Embase、拉丁美洲和加勒比地区卫生科学数据库(LILACS)以及医学文献数据库(MEDLINE),查找研究MCTs摄入对成年人身体成分影响的RCTs。两位作者独立提取数据并评估偏倚风险。计算结局净变化的加权平均差(WMDs)。我们通过Cochrane Q检验和I²统计量评估异质性,并通过Egger检验评估发表偏倚。进行了预先设定的敏感性分析。

结果

总共纳入了11项试验,其中5项偏倚风险较低。在总体分析中,包括所有研究,用MCTs替代膳食LCTs的个体体重显著降低(WMD,-0.69千克;95%置信区间[CI],-1.1至-0.28;p = 0.001);体脂(-0.89千克;95% CI,-1.27至-0.51;p < 0.001),腰围(-1.78厘米;95% CI,-2.4至-1.1;p < 0.001)也显著降低。证据的总体质量为低到中等。交叉设计的试验导致了异质性。

结论

尽管结果具有统计学意义,但用MCTs替代膳食LCTs的建议必须谨慎采纳,因为现有证据质量并非最高。

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