Wolfram Günther, Bechthold Angela, Boeing Heiner, Ellinger Sabine, Hauner Hans, Kroke Anja, Leschik-Bonnet Eva, Linseisen Jakob, Lorkowski Stefan, Schulze Matthias, Stehle Peter, Dinter Jessica
Ann Nutr Metab. 2015;67(3):141-204. doi: 10.1159/000437243. Epub 2015 Sep 29.
As nutrition-related chronic diseases have become more and more frequent, the importance of dietary prevention has also increased. Dietary fat plays a major role in human nutrition, and modification of fat and/or fatty acid intake could have a preventive potential. The aim of the guideline of the German Nutrition Society (DGE) was to systematically evaluate the evidence for the prevention of the widespread diseases obesity, type 2 diabetes mellitus, dyslipoproteinaemia, hypertension, metabolic syndrome, coronary heart disease (CHD), stroke, and cancer through the intake of fat or fatty acids. The main results can be summarized as follows: it was concluded with convincing evidence that a reduced intake of total and saturated fat as well as a larger intake of polyunsaturated fatty acids (PUFA) at the expense of saturated fatty acids (SFA) reduces the concentration of total and low-density lipoprotein cholesterol in plasma. Furthermore, there is convincing evidence that a high intake of trans fatty acids increases risk of dyslipoproteinaemia and that a high intake of long-chain polyunsaturated n-3 fatty acids reduces the triglyceride concentration in plasma. A high fat intake increases the risk of obesity with probable evidence when total energy intake is not controlled for (ad libitum diet). When energy intake is controlled for, there is probable evidence for no association between fat intake and risk of obesity. A larger intake of PUFA at the expense of SFA reduces risk of CHD with probable evidence. Furthermore, there is probable evidence that a high intake of long-chain polyunsaturated n-3 fatty acids reduces risk of hypertension and CHD. With probable evidence, a high trans fatty acid intake increases risk of CHD. The practical consequences for current dietary recommendations are described at the end of this article.
随着与营养相关的慢性疾病越来越常见，饮食预防的重要性也日益增加。膳食脂肪在人类营养中起着主要作用，改变脂肪和/或脂肪酸的摄入量可能具有预防潜力。德国营养学会（DGE）指南的目的是系统评估通过摄入脂肪或脂肪酸预防肥胖、2型糖尿病、血脂异常、高血压、代谢综合征、冠心病（CHD）、中风和癌症等常见疾病的证据。主要结果可总结如下：有确凿证据表明，减少总脂肪和饱和脂肪的摄入量，以及以饱和脂肪酸（SFA）为代价增加多不饱和脂肪酸（PUFA）的摄入量，可降低血浆中总胆固醇和低密度脂蛋白胆固醇的浓度。此外，有确凿证据表明，高反式脂肪酸摄入量会增加血脂异常的风险，而高长链多不饱和n-3脂肪酸摄入量可降低血浆甘油三酯浓度。当不控制总能量摄入（随意饮食）时，高脂肪摄入增加肥胖风险，这有很可能的证据。当控制能量摄入时，有很可能的证据表明脂肪摄入与肥胖风险之间无关联。以SFA为代价增加PUFA的摄入量可降低冠心病风险，这有很可能的证据。此外，有很可能的证据表明，高长链多不饱和n-3脂肪酸摄入量可降低高血压和冠心病风险。有很可能的证据表明，高反式脂肪酸摄入量会增加冠心病风险。本文末尾描述了对当前饮食建议的实际影响。
