Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-500, Baltimore, MD, 21287, USA.
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
Curr Atheroscler Rep. 2021 Mar 30;23(6):26. doi: 10.1007/s11883-021-00921-8.
Healthy dietary patterns are recommended for prevention of CVD. Recently, metabolomics has been used to identify biomarkers of healthy dietary patterns and elucidate mechanisms underlying diet-disease associations. This review provides an overview of approaches to define healthy dietary patterns, discusses important issues related to using metabolomics to describe healthy dietary patterns, and summarizes studies identifying blood metabolites associated with hypothesis-driven healthy dietary patterns and cardiovascular risk factors and incident CVD.
We identified 17 studies which reported on blood metabolomic signatures of 5 healthy dietary patterns (Healthy Eating Index, Alternative Healthy Eating Index, the Dietary Approaches to Stop Hypertension diet, Mediterranean diet, vegetarian diet). Four of these studies evaluated associations between diet-related metabolites and cardiovascular outcomes. Many metabolites replicated across different healthy dietary patterns, which suggest that they may represent biomarkers of generally healthy diets. Unsaturated lipids positively associated with healthy dietary patterns were inversely associated with incident CVD, suggesting that they may be a pathway through which diet is associated with a lower risk of CVD. Although many metabolites replicated across cross-sectional studies, few metabolites identified as candidate biomarkers of healthy diets in feeding studies replicated in observational studies. Additionally, limited evidence exists on the ability of diet-related metabolites to predict cardiovascular outcomes. Replication of candidate biomarkers of dietary patterns in different study designs and more studies evaluating the associations between diet-related metabolites and cardiovascular outcomes are needed.
综述目的：健康的饮食模式被推荐用于预防 CVD。最近，代谢组学已被用于鉴定健康饮食模式的生物标志物，并阐明饮食与疾病之间关联的机制。本综述概述了定义健康饮食模式的方法，讨论了使用代谢组学来描述健康饮食模式的重要问题，并总结了确定与假设驱动的健康饮食模式和心血管风险因素及 CVD 发病相关的血液代谢物的研究。
最近发现：我们确定了 17 项研究，这些研究报告了 5 种健康饮食模式（健康饮食指数、替代健康饮食指数、停止高血压的饮食方法、地中海饮食、素食饮食）的血液代谢组学特征。其中 4 项研究评估了与饮食相关的代谢物与心血管结局之间的关联。许多代谢物在不同的健康饮食模式中都有复制，这表明它们可能代表一般健康饮食的生物标志物。与健康饮食模式呈正相关的不饱和脂质与 CVD 发病呈负相关，这表明它们可能是饮食与 CVD 风险降低相关的途径。尽管许多代谢物在横断面研究中得到了复制，但在观察性研究中，在喂养研究中确定为健康饮食生物标志物的候选代谢物却很少得到复制。此外，关于饮食相关代谢物预测心血管结局的能力的证据有限。需要在不同的研究设计中复制饮食模式的候选生物标志物，并开展更多研究评估饮食相关代谢物与心血管结局之间的关联。
