生酮饮食对心血管疾病风险因素的影响：系统评价和随机对照试验的荟萃分析。
Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
机构信息
Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics.
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Adv Nutr. 2019 Jul 1;10(4):634-646. doi: 10.1093/advances/nmz007.
There is some evidence supporting the beneficial effects of a Paleolithic Diet (PD) on cardiovascular disease risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on cardiovascular disease risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August, 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = -2.17 kg; 95% CI: -3.48, -0.87 kg], waist circumference (WMD = -2.90 cm; 95% CI: -4.51, -1.28 cm), body mass index (in kg/m2) (WMD = -1.15; 95% CI: -1.68, -0.62), body fat percentage (WMD = -1.38%; 95% CI: -2.08%, -0.67%), systolic (WMD = -4.24 mm Hg; 95% CI: -7.11, -1.38 mm Hg) and diastolic (WMD = -2.95 mm Hg; 95% CI: -4.72, -1.18 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = -0.22 mg/dL; 95% CI: -0.42, -0.03 mg/dL), TGs (WMD = -0.23 mg/dL; 95% CI: -0.46, -0.01 mg/dL), LDL cholesterol (WMD = -0.13 mg/dL; 95% CI: -0.25, -0.01 mg/dL), and C-reactive protein (CRP) (WMD = -0.41 mg/L; 95% CI: -0.81, -0.008 mg/L) and also significantly increased HDL cholesterol (WMD = 0.05 mg/dL; 95% CI: 0.005, 0.10 mg/dL). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, blood pressure, and circulating CRP concentrations were significantly influenced by removing some studies, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on cardiovascular disease risk factors, the evidence is not conclusive and more well-designed trials are still needed.
有一些证据支持原始人饮食（PD）对心血管疾病风险因素的有益影响。这种饮食建议食用瘦肉、鱼、蔬菜、水果和坚果，避免摄入谷物、乳制品、加工食品以及添加糖和盐。本研究旨在评估 PD 对心血管疾病风险因素的影响，包括人体测量指数、血脂谱、血压和炎症标志物，使用来自随机对照试验的数据。在 2018 年 8 月之前，我们在 PubMed、Scopus、ISI Web of Science 和 Google Scholar 数据库中进行了全面检索。使用随机效应模型进行荟萃分析，以估计合并效应量。对 8 项合格研究的荟萃分析显示，PD 可显著降低体重[加权均数差（WMD）=-2.17kg；95%CI：-3.48，-0.87kg]、腰围（WMD=-2.90cm；95%CI：-4.51，-1.28cm）、体重指数（kg/m2）（WMD=-1.15；95%CI：-1.68，-0.62）、体脂百分比（WMD=-1.38%；95%CI：-2.08%，-0.67%）、收缩压（WMD=-4.24mmHg；95%CI：-7.11，-1.38mmHg）和舒张压（WMD=-2.95mmHg；95%CI：-4.72，-1.18mmHg）、总胆固醇（WMD=-0.22mg/dL；95%CI：-0.42，-0.03mg/dL）、甘油三酯（WMD=-0.23mg/dL；95%CI：-0.46，-0.01mg/dL）、低密度脂蛋白胆固醇（WMD=-0.13mg/dL；95%CI：-0.25，-0.01mg/dL）和 C 反应蛋白（CRP）（WMD=-0.41mg/L；95%CI：-0.81，-0.008mg/L），同时显著增加高密度脂蛋白胆固醇（WMD=0.05mg/dL；95%CI：0.005，0.10mg/dL）。然而，敏感性分析显示，PD 对血脂谱、血压和循环 CRP 浓度的总体影响受到去除一些研究的显著影响，因此必须谨慎解释结果。尽管本荟萃分析显示 PD 对心血管疾病风险因素有有利影响，但证据并不确凿，仍需要更多精心设计的试验。
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