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膳食脂肪与动脉粥样硬化:从儿童到成年。

Dietary Fats and Atherosclerosis From Childhood to Adulthood.

机构信息

Research Centre of Applied and Preventive Cardiovascular Medicine and Centre for Population Health Research and

Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Departments of Physical Activity and Health and.

出版信息

Pediatrics. 2020 Apr;145(4). doi: 10.1542/peds.2019-2786. Epub 2020 Mar 24.

DOI:10.1542/peds.2019-2786
PMID:32209700
Abstract

BACKGROUND

The association of dietary fat distribution with markers of subclinical atherosclerosis during early life is unknown. We examined whether success in achieving the main target of an infancy-onset dietary intervention based on the distribution of dietary fat was associated with aortic and carotid intima-media thickness (IMT) and distensibility from childhood to young adulthood.

METHODS

In the prospective randomized controlled Special Turku Coronary Risk Factor Intervention Project trial, personalized dietary counseling was given biannually to healthy children from infancy to young adulthood. The counseling was based on Nordic Nutrition Recommendations, with the main aim of improving the distribution of dietary fat in children's diets. IMT and distensibility of the abdominal aorta and common carotid artery were measured repeatedly at ages 11 ( = 439), 13 ( = 499), 15 ( = 506), 17 ( = 477), and 19 years ( = 429). The targeted distribution of dietary fat was defined as a ratio of saturated fatty acids to monounsaturated and polyunsaturated fatty acids of <1:2 and as an intake of saturated fatty acids of <10% of energy intake. Participants who met ≥1 of these 2 criteria were defined to achieve the main intervention target.

RESULTS

Individuals who achieved the main intervention target had lower aortic IMT (age- and sex-adjusted mean difference 10.4 µm; 95% confidence interval: 0.3 to 20.5 µm) and better aortic distensibility (0.13% per 10 mm Hg; 95% confidence interval: 0.00% to 0.26% per10 mm Hg) compared with their peers who did not meet the target.

CONCLUSIONS

Achieving the main target of an infancy-onset dietary intervention, reflecting dietary guidelines, was favorably associated with aortic IMT and distensibility during the early life course. These data support the recommendation of favoring unsaturated fat to enhance arterial health.

摘要

背景

目前尚不清楚饮食脂肪分布与早期亚临床动脉粥样硬化标志物之间的关系。我们研究了婴儿期开始的饮食干预的主要目标是否成功,即根据饮食脂肪分布来实现该目标,是否与儿童到青年期的主动脉和颈动脉内膜-中层厚度(IMT)和扩张性有关。

方法

在前瞻性随机对照的特殊图尔库冠状动脉危险因素干预研究试验中,从婴儿期到青年期,每年两次对健康儿童进行个性化饮食咨询。咨询以北欧营养建议为基础,主要目的是改善儿童饮食中脂肪的分布。在 11 岁(n = 439)、13 岁(n = 499)、15 岁(n = 506)、17 岁(n = 477)和 19 岁(n = 429)时,多次测量腹主动脉和颈总动脉的 IMT 和扩张性。饮食中脂肪的目标分布定义为饱和脂肪酸与单不饱和和多不饱和脂肪酸的比例<1:2,以及饱和脂肪酸摄入量占能量摄入的<10%。达到这两个标准中的至少一个标准的参与者被定义为达到主要干预目标。

结果

达到主要干预目标的个体的主动脉 IMT 较低(年龄和性别调整后的平均差异为 10.4 µm;95%置信区间:0.3 至 20.5 µm),主动脉扩张性更好(每 10 毫米汞柱增加 0.13%;95%置信区间:每 10 毫米汞柱增加 0.00%至 0.26%)与未达到目标的同龄人相比。

结论

实现婴儿期开始的饮食干预的主要目标,反映饮食指南,与生命早期的主动脉 IMT 和扩张性呈正相关。这些数据支持推荐优先使用不饱和脂肪来增强动脉健康。

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