Stoica Roxana Adriana, Diaconu Camelia Cristina, Rizzo Manfredi, Toth Peter P, Stefan Simona Diana, Serafinceanu Cristian, Nikolic Dragana, Poiana Catalina, Ionescu-Tirgoviste Constantin, Pantea-Stoian Anca
Department of Diabetes, Nutrition and Metabolic Diseases, 'Carol Davila' University of Medicine and Pharmacy, 020475 Bucharest, Romania.
Department of Internal Medicine, 'Carol Davila' University of Medicine and Pharmacy, 014461 Bucharest, Romania.
Exp Ther Med. 2021 Jan;21(1):90. doi: 10.3892/etm.2020.9522. Epub 2020 Nov 26.
Cardiovascular risk (CVR) is a broad term that includes traditional factors like hypertension, hyper lipidemia, abdominal obesity, hyperinsulinemia or overt type 2 diabetes mellitus (T2DM), and emerging ones such as hypothyroidism or inflammatory diseases. In epidemiologic studies, all of these factors are associated with atherogenesis and have complex interactions between them. They have in common an increased prevalence in the general population beginning in childhood, and are correlated with endothelial damage as demonstrated by echocardiographic modifications of the left ventricle or carotid intima-media thickness. Adolescence is a transition period where behavioural eating patterns develop and have a major impact on cardiovascular risk. To address these patterns, weight-loss programmes under medical supervision for overweight and obese adolescents are developed. It was observed that those who control the quality and quantity of their carbohydrates, by consuming more fruits and vegetables, associated with increased physical activity reduce their CVR. Some limited studies have shown that low carbohydrate diet (LCD) is safe and effective, but one should take into consideration the limited duration and the structure of the LCD. If there is a proper adherence to this type of nutritional intervention, it results in weight loss, improvement in insulin resistance, lipid profile and subclinical hypothyroidism reversal. We reviewed the literature starting from 2009 by searching all the observational, randomised clinical trials and meta-analyses on MEDLINE and SCOPUS databases regarding obesity and related metabolic diseases (dyslipidemia, type 2 diabetes, hypertension, hypothyroidism, LCD) in adolescents and synthesized the nutritional interventions for this population that could decrease CVR.
心血管风险（CVR）是一个广义术语，包括高血压、高脂血症、腹型肥胖、高胰岛素血症或显性2型糖尿病（T2DM）等传统因素，以及甲状腺功能减退或炎症性疾病等新出现的因素。在流行病学研究中，所有这些因素都与动脉粥样硬化的发生有关，且它们之间存在复杂的相互作用。它们的共同特点是在儿童期开始，普通人群中的患病率就有所增加，并且与左心室或颈动脉内膜中层厚度的超声心动图改变所显示的内皮损伤相关。青春期是一个行为饮食模式形成的过渡时期，对心血管风险有重大影响。为了应对这些模式，针对超重和肥胖青少年制定了医学监督下的减肥计划。据观察，那些通过多吃水果和蔬菜来控制碳水化合物质量和数量，并增加体育活动的人，其心血管风险会降低。一些有限的研究表明，低碳水化合物饮食（LCD）是安全有效的，但应考虑到低碳水化合物饮食的持续时间有限和结构特点。如果能正确坚持这种营养干预，会导致体重减轻、胰岛素抵抗改善、血脂谱改善以及亚临床甲状腺功能减退的逆转。我们通过检索MEDLINE和SCOPUS数据库中关于青少年肥胖及相关代谢疾病（血脂异常、2型糖尿病、高血压、甲状腺功能减退、低碳水化合物饮食）的所有观察性研究、随机临床试验和荟萃分析，回顾了从2009年开始的文献，并综合了针对该人群可降低心血管风险的营养干预措施。
