地中海饮食辅以乳制品可改善心血管风险标志物：来自 MedDairy 随机对照试验的结果。

A Mediterranean diet supplemented with dairy foods improves markers of cardiovascular risk: results from the MedDairy randomized controlled trial.

机构信息

Alliance for Research in Exercise, Nutrition, and Activity, School of Health Sciences.

School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.

出版信息

Am J Clin Nutr. 2018 Dec 1;108(6):1166-1182. doi: 10.1093/ajcn/nqy207.

DOI:10.1093/ajcn/nqy207

PMID:30351388

Abstract

BACKGROUND

The Mediterranean diet (MedDiet) offers benefits to cardiovascular health but may not meet Western recommendations for calcium and dairy intake, which could impede long-term adoption.

OBJECTIVE

The current study aimed to determine the effect of a MedDiet supplemented with dairy foods on cardiovascular risk factors.

DESIGN

A randomized, controlled, crossover design compared a MedDiet with 3-4 daily servings of dairy (MedDairy) and a low-fat (LF) control diet. Forty-one participants aged ≥45 y and at risk of cardiovascular disease (CVD) were randomly allocated to their first intervention, either the MedDairy or LF diet. Participants followed each intervention for 8 wk, and an 8-wk washout period separated interventions. The primary outcome was home-measured systolic blood pressure (SBP) assessed in the morning, afternoon, and evening. Secondary outcomes included clinic-measured blood pressure (morning), body composition, blood lipids, C-reactive protein (CRP), plasma glucose, serum insulin, and the Framingham Risk Score.

RESULTS

Compared with the LF intervention, the MedDairy intervention resulted in a significantly lower morning SBP (mean difference: -1.6 mm Hg; 95% CI: -2.8, -0.4 mm Hg; P = 0.01), lower morning diastolic blood pressure (mean difference: -1.0; 95% CI: -1.7, -0.2 mm Hg; P = 0.01) and clinic SBP (mean difference: -3.5 mm Hg; 95% CI: -6.4, -0.7 mm Hg; P = 0.02), significantly higher HDL cholesterol (mean difference: 0.04 mmol/L; 95% CI: 0.01, 0.06 mmol/L; P < 0.01), lower triglycerides (mean difference: = -0.05 mmol/L; 95% CI: -0.08, -0.01 mmol/L; P < 0.01), and lower ratio of total to HDL cholesterol (mean difference: -0.4; 95% CI: -0.6, -0.2; P < 0.001). No effects were observed for other outcome measures.

CONCLUSIONS

Following a MedDiet with additional dairy foods led to significant changes in markers of cardiovascular risk over 8 wk. The MedDiet supplemented with dairy may be appropriate for an improvement in cardiovascular risk factors in a population at risk of CVD. This trial was registered at anzctr.org.au as ACTRN12616000309482.

摘要

背景

地中海饮食（MedDiet）对心血管健康有益，但可能无法满足西方对钙和乳制品摄入量的建议，这可能会阻碍其长期采用。

目的

本研究旨在确定富含乳制品的地中海饮食对心血管危险因素的影响。

设计

一项随机、对照、交叉设计比较了地中海饮食加 3-4 份日常乳制品（MedDairy）和低脂（LF）对照饮食。41 名年龄≥45 岁且有心血管疾病（CVD）风险的参与者被随机分配到他们的第一个干预组，即 MedDairy 或 LF 饮食组。参与者分别遵循每个干预 8 周，8 周洗脱期将干预分开。主要结局是在家测量的清晨、下午和傍晚的收缩压（SBP）。次要结局包括诊所测量的血压（清晨）、身体成分、血脂、C 反应蛋白（CRP）、血浆葡萄糖、血清胰岛素和弗雷明汉风险评分。

结果

与 LF 干预相比，MedDairy 干预导致清晨 SBP 显著降低（平均差异：-1.6mmHg；95%CI：-2.8，-0.4mmHg；P=0.01），清晨舒张压（平均差异：-1.0mmHg；95%CI：-1.7，-0.2mmHg；P=0.01）和诊所 SBP（平均差异：-3.5mmHg；95%CI：-6.4，-0.7mmHg；P=0.02）显著升高，高密度脂蛋白胆固醇（HDL-C）（平均差异：0.04mmol/L；95%CI：0.01，0.06mmol/L；P<0.01），甘油三酯（平均差异：=-0.05mmol/L；95%CI：-0.08，-0.01mmol/L；P<0.01），总胆固醇/高密度脂蛋白胆固醇比值（平均差异：-0.4；95%CI：-0.6，-0.2；P<0.001）也有所降低。其他结局指标无影响。