Yokoyama Yoko, Levin Susan M, Barnard Neal D
Graduate School of Media and Governance, Keio University, Fujisawa, Kanagawa, Japan.
Physicians Committee for Responsible Medicine, Washington, DC, USA.
Nutr Rev. 2017 Sep 1;75(9):683-698. doi: 10.1093/nutrit/nux030.
Although a recent meta-analysis of randomized controlled trials showed that adoption of a vegetarian diet reduces plasma lipids, the association between vegetarian diets and long-term effects on plasma lipids has not been subjected to meta-analysis.
The aim was to conduct a systematic review and meta-analysis of observational studies and clinical trials that have examined associations between plant-based diets and plasma lipids.
MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for articles published in English until June 2015.
The literature was searched for controlled trials and observational studies that investigated the effects of at least 4 weeks of a vegetarian diet on plasma lipids.
Two reviewers independently extracted the study methodology and sample size, the baseline characteristics of the study population, and the concentrations and variance measures of plasma lipids. Mean differences in concentrations of plasma lipids between vegetarian and comparison diet groups were calculated. Data were pooled using a random-effects model.
Of the 8385 studies identified, 30 observational studies and 19 clinical trials met the inclusion criteria (N = 1484; mean age, 48.6 years). Consumption of vegetarian diets was associated with lower mean concentrations of total cholesterol (-29.2 and -12.5 mg/dL, P < 0.001), low-density lipoprotein cholesterol (-22.9 and -12.2 mg/dL, P < 0.001), and high-density lipoprotein cholesterol (-3.6 and -3.4 mg/dL, P < 0.001), compared with consumption of omnivorous diets in observational studies and clinical trials, respectively. Triglyceride differences were -6.5 (P = 0.092) in observational studies and 5.8 mg/dL (P = 0.090) in intervention trials.
Plant-based diets are associated with decreased total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, but not with decreased triglycerides.
PROSPERO number CRD42015023783. Available at: https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023783.
尽管最近一项对随机对照试验的荟萃分析表明，采用素食饮食可降低血脂，但素食饮食与血脂长期影响之间的关联尚未进行荟萃分析。
旨在对研究植物性饮食与血脂之间关联的观察性研究和临床试验进行系统评价和荟萃分析。
检索MEDLINE、科学网和Cochrane对照试验中央注册库中截至2015年6月以英文发表的文章。
检索文献以查找对照试验和观察性研究，这些研究调查了至少4周的素食饮食对血脂的影响。
两名评价员独立提取研究方法和样本量、研究人群的基线特征以及血脂的浓度和方差测量值。计算素食饮食组和对照饮食组之间血脂浓度的平均差异。使用随机效应模型汇总数据。
在鉴定出的8385项研究中，30项观察性研究和19项临床试验符合纳入标准（N = 1484；平均年龄48.6岁）。在观察性研究和临床试验中，与食用杂食性饮食相比，食用素食饮食分别与总胆固醇平均浓度降低（-29.2和-12.5mg/dL，P<0.001）、低密度脂蛋白胆固醇降低（-22.9和-12.2mg/dL，P<0.001）和高密度脂蛋白胆固醇降低（-3.6和-3.4mg/dL，P<0.001）相关。在观察性研究中甘油三酯差异为-6.5（P = 0.092），在干预试验中为5.8mg/dL（P = 0.090）。
植物性饮食与总胆固醇、低密度脂蛋白胆固醇降低以及高密度脂蛋白胆固醇降低相关，但与甘油三酯降低无关。
PROSPERO编号CRD42015023783。可在以下网址获取：https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023783 。
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