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不同类型膳食蛋白质(动物蛋白与植物蛋白)对心血管代谢危险因素的影响:国际脂质专家小组(ILEP)的立场文件。

The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP).

机构信息

Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.

Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; University of Prishtina, Medical Faculty, Prishtina, Kosovo; Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden.

出版信息

Clin Nutr. 2021 Jan;40(1):255-276. doi: 10.1016/j.clnu.2020.05.017. Epub 2020 May 26.

Abstract

Proteins play a crucial role in metabolism, in maintaining fluid and acid-base balance and antibody synthesis. Dietary proteins are important nutrients and are classified into: 1) animal proteins (meat, fish, poultry, eggs and dairy), and, 2) plant proteins (legumes, nuts and soy). Dietary modification is one of the most important lifestyle changes that has been shown to significantly decrease the risk of cardiovascular (CV) disease (CVD) by attenuating related risk factors. The CVD burden is reduced by optimum diet through replacement of unprocessed meat with low saturated fat, animal proteins and plant proteins. In view of the available evidence, it has become acceptable to emphasize the role of optimum nutrition to maintain arterial and CV health. Such healthy diets are thought to increase satiety, facilitate weight loss, and improve CV risk. Different studies have compared the benefits of omnivorous and vegetarian diets. Animal protein related risk has been suggested to be greater with red or processed meat over and above poultry, fish and nuts, which carry a lower risk for CVD. In contrast, others have shown no association of red meat intake with CVD. The aim of this expert opinion recommendation was to elucidate the different impact of animal vs vegetable protein on modifying cardiometabolic risk factors. Many observational and interventional studies confirmed that increasing protein intake, especially plant-based proteins and certain animal-based proteins (poultry, fish, unprocessed red meat low in saturated fats and low-fat dairy products) have a positive effect in modifying cardiometabolic risk factors. Red meat intake correlates with increased CVD risk, mainly because of its non-protein ingredients (saturated fats). However, the way red meat is cooked and preserved matters. Thus, it is recommended to substitute red meat with poultry or fish in order to lower CVD risk. Specific amino acids have favourable results in modifying major risk factors for CVD, such as hypertension. Apart from meat, other animal-source proteins, like those found in dairy products (especially whey protein) are inversely correlated to hypertension, obesity and insulin resistance.

摘要

蛋白质在新陈代谢、维持体液和酸碱平衡以及抗体合成中起着至关重要的作用。膳食蛋白质是重要的营养素,可分为:1)动物蛋白质(肉、鱼、禽、蛋和乳制品),和 2)植物蛋白质(豆类、坚果和大豆)。膳食调整是最重要的生活方式改变之一,已被证明可通过减弱相关风险因素显著降低心血管疾病(CVD)的风险。通过用低饱和脂肪、动物蛋白质和植物蛋白质代替未加工的肉类,最优饮食可降低 CVD 负担。鉴于现有证据,强调最佳营养在维持动脉和心血管健康方面的作用已被认可。这些健康饮食被认为可增加饱腹感、促进体重减轻,并改善心血管风险。不同的研究比较了杂食和素食饮食的益处。与家禽、鱼类和坚果相比,动物蛋白质相关的风险更高,因为红色或加工肉类与 CVD 风险增加有关,而红色或加工肉类与 CVD 风险增加有关。相比之下,其他人则没有发现红色肉类摄入量与 CVD 之间的关联。本专家意见建议的目的是阐明动物蛋白与植物蛋白对改变心血管代谢危险因素的不同影响。许多观察性和干预性研究证实,增加蛋白质摄入,特别是植物性蛋白质和某些动物性蛋白质(家禽、鱼类、低饱和脂肪和低脂乳制品的未加工红色肉类),对改变心血管代谢危险因素有积极影响。红色肉类摄入量与 CVD 风险增加相关,主要是因为其非蛋白质成分(饱和脂肪)。然而,红色肉类的烹饪和保存方式很重要。因此,建议用家禽或鱼类代替红色肉类,以降低 CVD 风险。特定的氨基酸在改变 CVD 的主要危险因素方面有良好的效果,如高血压。除了肉类,其他动物来源的蛋白质,如乳制品(尤其是乳清蛋白)中的蛋白质,与高血压、肥胖和胰岛素抵抗呈负相关。

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