The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA, USA.
Nat Rev Cardiol. 2019 Oct;16(10):581-601. doi: 10.1038/s41569-019-0206-1.
The effect of dietary fats on cardiometabolic diseases, including cardiovascular diseases and type 2 diabetes mellitus, has generated tremendous interest. Many earlier investigations focused on total fat and conventional fat classes (such as saturated and unsaturated fats) and their influence on a limited number of risk factors. However, dietary fats comprise heterogeneous molecules with diverse structures, and growing research in the past two decades supports correspondingly complex health effects of individual dietary fats. Moreover, health effects of dietary fats might be modified by additional factors, such as accompanying nutrients and food-processing methods, emphasizing the importance of the food sources. Accordingly, the rapidly increasing scientific findings on dietary fats and cardiometabolic diseases have generated debate among scientists, caused confusion for the general public and present challenges for translation into dietary advice and policies. This Review summarizes the evidence on the effects of different dietary fats and their food sources on cell function and on risk factors and clinical events of cardiometabolic diseases. The aim is not to provide an exhaustive review but rather to focus on the most important evidence from randomized controlled trials and prospective cohort studies and to highlight current areas of controversy and the most relevant future research directions for understanding how to improve the prevention and management of cardiometabolic diseases through optimization of dietary fat intake.
膳食脂肪对心血管疾病和 2 型糖尿病等代谢性心血管疾病的影响引起了极大的关注。许多早期的研究集中在总脂肪和传统脂肪类别(如饱和脂肪和不饱和脂肪)及其对有限数量的风险因素的影响上。然而,膳食脂肪由具有不同结构的异质分子组成,过去二十年的研究表明,不同的膳食脂肪对健康有相应复杂的影响。此外,膳食脂肪的健康影响可能会受到其他因素的影响,如伴随的营养素和食品加工方法,这强调了食物来源的重要性。因此,关于膳食脂肪和代谢性心血管疾病的快速增加的科学发现引起了科学家之间的争论,也给公众造成了困惑,并对将其转化为饮食建议和政策提出了挑战。这篇综述总结了不同膳食脂肪及其食物来源对细胞功能以及代谢性心血管疾病的风险因素和临床事件的影响的证据。本综述的目的不是提供详尽的综述,而是重点关注随机对照试验和前瞻性队列研究中最重要的证据,并强调目前存在争议的领域和最相关的未来研究方向,以了解如何通过优化膳食脂肪摄入来改善代谢性心血管疾病的预防和管理。