a German Nutrition Society , Bonn , Germany.
b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany.
Crit Rev Food Sci Nutr. 2019;59(7):1071-1090. doi: 10.1080/10408398.2017.1392288. Epub 2017 Nov 7.
Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).
We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.
Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RR: 0.95 (95% CI: 0.92-0.98), RR: 0.96 (0.95-0.97)), vegetables and fruits (RR: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RR: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RR: 0.67 (0.43-1.05)), and fish consumption (RR: 0.88 (0.79-0.99), RR: 0.86 (0.75-0.99), and RR: 0.80 (0.67-0.95)), while a positive association was present for egg (RR: 1.16 (1.03-1.31)), red meat (RR: 1.15 (1.08-1.23), RR: 1.12 (1.06-1.17), RR: 1.08 (1.02-1.14)), processed meat (RR: 1.27 (1.09-1.49), RR: 1.17 (1.02-1.34), RR: 1.12 (1.05-1.19)), and SSB consumption (RR: 1.17 (1.11-1.23), RR: 1.07 (1.02-1.12), RR: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.
An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
尽管有越来越多的证据表明饮食模式与降低心血管疾病风险之间存在关联，但关于与特定心血管结局风险变化最大相关的食物量以及关于元证据质量的知识有限。因此，本荟萃分析的目的是综合了解 12 种主要食物组（全谷物、精制谷物、蔬菜、水果、坚果、豆类、鸡蛋、乳制品、鱼类、红肉、加工肉和含糖饮料[SSB]）与冠心病（CHD）、中风和心力衰竭（HF）风险之间的关系。
我们在 PubMed 和 Embase 上进行了系统检索，检索时间截至 2017 年 3 月，以纳入前瞻性研究。使用随机效应模型估算最高与最低摄入量类别之间的汇总风险比（RR）和 95%置信区间（95%CI），以及线性和非线性关系。
总体而言，共有 123 份报告纳入荟萃分析。全谷物（RR：0.95（95%CI：0.92-0.98），RR：0.96（0.95-0.97））、蔬菜和水果（RR：0.97（0.96-0.99）和 0.94（0.90-0.97）；RR：0.92（0.86-0.98）和 0.90（0.84-0.97））、坚果（RR：0.67（0.43-1.05））和鱼类消费（RR：0.88（0.79-0.99），RR：0.86（0.75-0.99）和 RR：0.80（0.67-0.95））呈负相关，而鸡蛋（RR：1.16（1.03-1.31））、红肉（RR：1.15（1.08-1.23），RR：1.12（1.06-1.17），RR：1.08（1.02-1.14））、加工肉（RR：1.27（1.09-1.49），RR：1.17（1.02-1.34），RR：1.12（1.05-1.19））和 SSB 消费（RR：1.17（1.11-1.23），RR：1.07（1.02-1.12），RR：1.08（1.05-1.12））在线性剂量反应荟萃分析中呈正相关。全谷物、水果、坚果、乳制品和红肉与 CHD 之间存在明确的非线性剂量反应关系。
全谷物、蔬菜、水果、坚果、豆类、乳制品、鱼类、红肉和加工肉、鸡蛋和 SSB 的最佳摄入量与 CHD、中风和 HF 的风险降低密切相关。
