Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
Maturitas. 2022 Jan;155:40-53. doi: 10.1016/j.maturitas.2021.10.001. Epub 2021 Oct 9.
Menopause is accompanied by many metabolic changes, increasing the risk of cardiometabolic diseases. The impact of diet, as a modifiable lifestyle factor, on cardiovascular health in general populations has been well established. The purpose of this systematic review is to summarize the evidence on the effects of whole diet on lipid profile, glycemic indices, and blood pressure in postmenopausal women.
Embase, Medline, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to February 2021. We included controlled clinical trials in postmenopausal women that assessed the effect of a whole-diet intervention on lipid profile, glycemic indices, and/or blood pressure. The risk of bias in individual studies was assessed using RoB 2 and ROBINS-I tools.
Among 2,134 references, 21 trials met all eligibility criteria. Overall, results were heterogenuous and inconsistent. Compared to control diets, some studies showed that participants experienced improvements in total cholesterol (TC), low-density lipoprotein cholesterol (LDL), systolic blood pressure (SBP), fasting blood sugar (FBS), and apolipoprotein A (Apo-A) after following fat-modified diets, but some adverse effects on triglycerides (TG), very low-density lipoprotein cholesterol (VLDL), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL) concentrations were also observed. A limited number of trials found some effects of the Paleolithic, weight-loss, plant-based, or energy-restricted diets, or of following American Heart Association recommendations on TG, TC, HDL, insulin, FBS, or insulin resistance.
Current evidence suggests that diet may affect levels of some lipid profile markers, glycemic indices, and blood pressure among postmenopausal women. However, due to the large heterogeneity in intervention diets, comparison groups, intervention durations, and population characteristics, findings are inconclusive. Further well-designed clinical trials are needed on dietary interventions to reduce cardiovascular risk in postmenopausal women.
绝经伴随着许多代谢变化，增加了患心血管疾病的风险。饮食作为一种可改变的生活方式因素，对一般人群的心血管健康的影响已得到充分证实。本系统评价的目的是总结关于整体饮食对绝经后妇女血脂谱、血糖指数和血压影响的证据。
从建库到 2021 年 2 月，我们在 Embase、Medline、Cochrane 对照试验中心注册库和 Google Scholar 上进行了检索。我们纳入了评估整体饮食干预对血脂谱、血糖指数和/或血压影响的绝经后妇女对照临床试验。使用 RoB 2 和 ROBINS-I 工具评估个体研究的偏倚风险。
在 2134 篇参考文献中，有 21 项试验符合所有入选标准。总体而言，结果存在异质性和不一致性。与对照饮食相比，一些研究表明，参与者在遵循脂肪改良饮食后，总胆固醇（TC）、低密度脂蛋白胆固醇（LDL）、收缩压（SBP）、空腹血糖（FBS）和载脂蛋白 A（Apo-A）有所改善，但也观察到一些不良影响，如甘油三酯（TG）、极低密度脂蛋白胆固醇（VLDL）、脂蛋白（a）（Lp（a））和高密度脂蛋白胆固醇（HDL）浓度升高。少数试验发现，一些采用原始人饮食、减肥饮食、植物性饮食或能量限制饮食，或遵循美国心脏协会关于 TG、TC、HDL、胰岛素、FBS 或胰岛素抵抗的建议，对 TG、TC、HDL、胰岛素、FBS 或胰岛素抵抗有一定的效果。
目前的证据表明，饮食可能会影响绝经后妇女某些血脂谱标志物、血糖指数和血压水平。然而，由于干预饮食、对照组、干预持续时间和人群特征的差异很大，结果尚不确定。需要进一步进行关于饮食干预以降低绝经后妇女心血管风险的精心设计的临床试验。
