Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, 20133 Milan, Italy.
IRCCS MultiMedica, Sesto San Giovanni, 20099 Milan, Italy.
Nutrients. 2022 Jan 30;14(3):606. doi: 10.3390/nu14030606.
The use of nutraceutical products and functional foods in the cardiovascular and metabolic field is rising in several countries. Preparation and implementation of guidelines are pivotal for translating research-derived knowledge and evidence-based medicine to the clinical practice. Based on these considerations, the aim of this paper is to explore if and how nutraceutical products are discussed by the most recent international guidelines related to cardio-metabolic diseases (dyslipidaemia, obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) prevention). Some, but not all, guidelines for dyslipidaemia mention nutraceutical products as potential useful options for the treatment of mild dyslipidaemia, but also indicate the low level of evidence associated to their effects on hard endpoints (myocardial infarction, stroke, CVD-related death). In the most recent guidelines on obesity, it is mentioned that no safe and effective dietary supplement nor nutraceutical product is available for the management of weight loss in this condition, and more high-quality studies are necessary in this field. The examined guidelines for T2DM do not mention any specific nutraceutical approach to this disease, nor to milder forms, such as insulin resistance and pre-diabetes.
The focus on nutraceutical products in the main international guidelines for cardio-metabolic disease management remains limited. Since robust scientific evidence is the background of useful and effective guidelines, the implementation of high-quality clinical research is strongly needed in the field of nutraceutical products for cardio-metabolic diseases.
在一些国家,营养保健品和功能性食品在心血管和代谢领域的应用正在增加。制定和实施指南对于将研究所得知识和循证医学转化为临床实践至关重要。基于这些考虑,本文旨在探讨最近与心血管代谢疾病(血脂异常、肥胖、2 型糖尿病(T2DM)和心血管疾病(CVD)预防)相关的国际指南是否以及如何讨论营养保健品。一些血脂异常指南提到营养保健品是治疗轻度血脂异常的潜在有用选择,但也指出了其对硬终点(心肌梗死、中风、CVD 相关死亡)影响的证据水平较低。在最近关于肥胖的指南中,提到在这种情况下,没有安全有效的膳食补充剂或营养保健品可用于管理体重减轻,并且在该领域需要更多高质量的研究。检查的 T2DM 指南没有提到任何针对这种疾病或更温和形式(如胰岛素抵抗和糖尿病前期)的特定营养保健品方法。
主要国际心血管代谢疾病管理指南对营养保健品的关注仍然有限。由于强有力的科学证据是有用和有效的指南的基础,因此在心血管代谢疾病营养保健品领域,需要大力开展高质量的临床研究。