全谷物饮食可降低超重和肥胖成年人的心血管危险因素：一项随机对照试验。
A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial.
作者信息
Kirwan John P, Malin Steven K, Scelsi Amanda R, Kullman Emily L, Navaneethan Sankar D, Pagadala Mangesh R, Haus Jacob M, Filion Julianne, Godin Jean-Philippe, Kochhar Sunil, Ross Alastair B
机构信息
Department of Pathobiology, Lerner Research Institute,
Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH.
出版信息
J Nutr. 2016 Nov;146(11):2244-2251. doi: 10.3945/jn.116.230508. Epub 2016 Oct 19.
BACKGROUND
Increased dietary whole-grain intake may protect against cardiovascular disease (CVD).
OBJECTIVE
The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults.
METHODS
We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia.
RESULTS
Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m): 33.1 ± 4.3]. Decreases in diastolic blood pressure were -5.8 mm Hg (95% CI: -7.7, -4.0 mm Hg) after the whole-grain diet and -1.6 mm Hg (95% CI: -4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were -0.1 (95% CI: -0.9, 0.7) after the whole-grain diet and -1.4 (95% CI: -2.6, -0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them.
CONCLUSIONS
The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at clinicaltrials.gov as NCT01411540.
背景
增加膳食中全谷物的摄入量可能预防心血管疾病（CVD）。
目的
评估超重和肥胖成年人食用全谷物与精制谷物相比，对身体成分、高血压及心血管疾病相关介质的影响。
方法
我们对40名年龄小于50岁、无心血管疾病病史的超重或肥胖男性和女性进行了一项双盲、随机、对照交叉试验。提供完整的全谷物和精制谷物饮食，各为期8周，两种饮食之间有10周的洗脱期。除了分别包含全谷物或精制谷物（每种饮食中50克/1000千卡）外，宏量营养素组成相匹配。测量指标包括血压、身体成分、血脂和脂联素，以及炎症和血糖标志物。
结果
33名参与者（6名男性和27名女性）完成了试验[平均±标准差年龄：39±7岁；平均±标准差体重指数（kg/m²）：33.1±4.3]。全谷物饮食后舒张压下降了-5.8毫米汞柱（95%置信区间：-7.7，-4.0毫米汞柱），对照饮食后下降了-1.6毫米汞柱（95%置信区间：-4.4，1.3毫米汞柱）（组间效应，P = 0.01）。全谷物饮食后血浆脂联素下降了-0.1（95%置信区间：-0.9，0.7）微克/毫升，对照饮食后下降了-1.4（95%置信区间：-2.6，-0.3）微克/毫升（组间效应，P = 0.05）。舒张压下降与循环脂联素浓度相关（r = 0.35，P = 0.04）。在两个饮食阶段均观察到体重、脂肪量、收缩压、总胆固醇和低密度脂蛋白胆固醇大幅下降，两者之间无显著差异。
结论
超重和肥胖成年人食用全谷物饮食时，舒张压的改善幅度比食用精制谷物饮食时大3倍以上。由于舒张压可预测小于50岁成年人的死亡率，增加全谷物摄入量可能是控制高血压的有效方法。这可能使有血管相关发病和死亡风险的患者受益。该试验已在clinicaltrials.gov注册，注册号为NCT01411540。
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