Tufts University Friedman School of Nutrition and Policy, Boston, MA.
Tufts Clinical Evidence Synthesis Center, Tufts Medical Center, Boston, MA.
Adv Nutr. 2019 Nov 1;10(6):1076-1088. doi: 10.1093/advances/nmz043.
Evidence suggests that eating nuts may reduce the risk of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating almond consumption and risk factors for CVD. MEDLINE, Cochrane Central, Commonwealth Agricultural Bureau, and previous systematic reviews were searched from 1990 through June 2017 for RCTs of ≥3 wk duration that evaluated almond compared with no almond consumption in adults who were either healthy or at risk for CVD. The most appropriate stratum was selected with an almond dose closer to 42.5 g, with a control most closely matched for macronutrient composition, energy intake, and similar intervention duration. The outcomes included risk factors for CVD. Random-effects model meta-analyses and subgroup meta-analyses were performed. Fifteen eligible trials analyzed a total of 534 subjects. Almond intervention significantly decreased total cholesterol (summary net change: -10.69 mg/dL; 95% CI: -16.75, -4.63 mg/dL), LDL cholesterol (summary net change: -5.83 mg/dL; 95% CI: -9.91, -1.75 mg/dL); body weight (summary net change: -1.39 kg; 95% CI: -2.49, -0.30 kg), HDL cholesterol (summary net change: -1.26 mg/dL; 95% CI: -2.47, -0.05 mg/dL), and apolipoprotein B (apoB) (summary net change: -6.67 mg/dL; 95% CI: -12.63, -0.72 mg/dL). Triglycerides, systolic blood pressure, apolipoprotein A1, high-sensitivity C-reactive protein, and lipoprotein (a) showed no difference between almond and control in the main and subgroup analyses. Fasting blood glucose, diastolic blood pressure, and body mass index significantly decreased with almond consumption of >42.5 g compared with ≤42.5 g. Almond consumption may reduce the risk of CVD by improving blood lipids and by decreasing body weight and apoB. Substantial heterogeneity in eligible studies regarding almond interventions and dosages precludes firmer conclusions.
证据表明，食用坚果可能降低心血管疾病（CVD）的风险。我们进行了一项系统评价和荟萃分析，评估了杏仁摄入量与 CVD 风险因素的随机对照试验（RCT）。从 1990 年到 2017 年 6 月，我们检索了 MEDLINE、Cochrane 中心、英联邦农业局和以前的系统评价，以评估杏仁摄入量与非杏仁摄入的成年人（健康或 CVD 风险）之间 ≥3 周的 RCT。选择最合适的分层，杏仁剂量接近 42.5g，对照组最接近宏量营养素组成、能量摄入和相似干预时间匹配。结果包括 CVD 的风险因素。进行了随机效应模型荟萃分析和亚组荟萃分析。15 项合格试验共分析了 534 名受试者。杏仁干预显著降低了总胆固醇（综合净变化：-10.69mg/dL；95%CI：-16.75，-4.63mg/dL）、LDL 胆固醇（综合净变化：-5.83mg/dL；95%CI：-9.91，-1.75mg/dL）；体重（综合净变化：-1.39kg；95%CI：-2.49，-0.30kg）、高密度脂蛋白胆固醇（综合净变化：-1.26mg/dL；95%CI：-2.47，-0.05mg/dL）和载脂蛋白 B（apoB）（综合净变化：-6.67mg/dL；95%CI：-12.63，-0.72mg/dL）。杏仁和对照组之间的甘油三酯、收缩压、载脂蛋白 A1、高敏 C 反应蛋白和脂蛋白（a）在主要和亚组分析中没有差异。与≤42.5g 相比，食用>42.5g 的杏仁可显著降低空腹血糖、舒张压和体重指数。杏仁的摄入可能通过改善血脂、降低体重和 apoB 来降低 CVD 的风险。纳入研究中杏仁干预和剂量存在显著异质性，无法得出更确切的结论。
