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维生素 D 强化酸奶是否是改善人类健康的增值策略?一项随机试验的系统评价和荟萃分析。

Is vitamin D-fortified yogurt a value-added strategy for improving human health? A systematic review and meta-analysis of randomized trials.

机构信息

Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, University of Pavia, 27100 Pavia, Italy.

Department of Biology, College of Science, University of Bahrain, Sakhir Campus, PO Box 32038, Kingdom of Bahrain.

出版信息

J Dairy Sci. 2019 Oct;102(10):8587-8603. doi: 10.3168/jds.2018-16046. Epub 2019 Aug 7.

Abstract

Yogurt is a good source of probiotics, calcium, and proteins, but its content of vitamin D is low. Therefore, yogurt could be a good choice for vitamin D fortification to improve the positive health outcomes associated with its consumption. The primary aim of this systematic review and meta-analysis was to investigate the effect of vitamin D-fortified yogurt compared with plain yogurt on levels of serum 25-hydroxy vitamin D (25OHD). The secondary aim was to evaluate the effect of fortified yogurt on parathyroid hormone, anthropometric parameters, blood pressure, glucose metabolism, and lipid profile. We searched PubMed, Scopus, and Google Scholar for eligible studies; that is, randomized controlled trials (RCT) that compared vitamin D-fortified yogurt with control treatment without any additional supplement. Random-effects models were used to estimate pooled effect sizes and 95% confidence intervals. Findings from 9 RCT (n = 665 participants) that lasted from 8 to 16 wk are summarized in this review. The meta-analyzed mean differences for random effects showed that vitamin D-fortified yogurt (from 400 to 2,000 IU) increased serum 25OHD by 31.00 nmol/L. In addition, vitamin D-fortified yogurt decreased parathyroid hormone by 15.47 ng/L, body weight by 0.92 kg, waist circumference by 2.01 cm, HOMA-IR by 2.18 mass units, fasting serum glucose by 22.54 mg/dL, total cholesterol by 13.38 mg/dL, and triglycerides by 30.12 mg/dL compared with the controlled treatments. No publication bias was identified. Considerable between-study heterogeneity was observed for most outcomes. Vitamin D-fortified yogurt may be beneficial in improving serum 25OHD, lipid profile, glucose metabolism, and anthropometric parameters and decreasing parathyroid hormone level in pregnant women and adult and elderly subjects with or without diabetes, prediabetes, or metabolic syndrome.

摘要

酸奶是益生菌、钙和蛋白质的良好来源,但维生素 D 含量较低。因此,酸奶可能是维生素 D 强化的良好选择,可以改善与其消费相关的积极健康结果。本系统评价和荟萃分析的主要目的是研究与普通酸奶相比,强化维生素 D 的酸奶对血清 25-羟维生素 D(25OHD)水平的影响。次要目的是评估强化酸奶对甲状旁腺激素、人体测量参数、血压、血糖代谢和血脂谱的影响。我们在 PubMed、Scopus 和 Google Scholar 上搜索了符合条件的研究,即比较强化维生素 D 的酸奶与不添加任何其他补充剂的对照治疗的随机对照试验(RCT)。我们使用随机效应模型来估计汇总效应大小和 95%置信区间。本综述总结了 9 项 RCT(n = 665 名参与者)的研究结果,这些 RCT 的持续时间从 8 周到 16 周不等。荟萃分析的随机效应均值差异表明,从 400 到 2000 IU 的强化维生素 D 酸奶可使血清 25OHD 增加 31.00 nmol/L。此外,强化维生素 D 的酸奶可使甲状旁腺激素降低 15.47ng/L,体重降低 0.92kg,腰围减少 2.01cm,HOMA-IR 降低 2.18 个单位,空腹血糖降低 22.54mg/dL,总胆固醇降低 13.38mg/dL,甘油三酯降低 30.12mg/dL,与对照治疗相比。未发现发表偏倚。大多数结果的研究间异质性较大。强化维生素 D 的酸奶可能对改善孕妇和患有或不患有糖尿病、前驱糖尿病或代谢综合征的成年和老年受试者的血清 25OHD、血脂谱、血糖代谢和人体测量参数以及降低甲状旁腺激素水平有益。

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