Givens D Ian
Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6EU, UK.
Proc Nutr Soc. 2023 Sep;82(3):329-345. doi: 10.1017/S0029665123000083. Epub 2023 Feb 6.
Type 2 diabetes (T2D) and CVD are major causes of mortality and chronic morbidity. Whilst mortality from CVD has decreased they remain the largest cause of death in Europe and the prevalence of T2D is increasing rapidly. A consistent component of public health advice is to reduce intake of SFA to reduce CVD in particular, which implies limiting dairy food consumption. The prospective studies and randomised controlled trials included in this review show that for dairy foods at least, SFA are not consistently associated with CVD or T2D risk. For CVD the association with dairy foods is generally neutral despite dairy foods being the major source of SFA in many diets. This creates considerable doubt, at least for dairy foods, concerning the validity of the traditional diet-heart hypothesis which positively relates SFA intake to increased serum LDL-cholesterol and subsequent increased CVD. There is now emerging evidence to explain this which is highly relevant to dairy foods. These include the potentially counterbalancing effect of SFA-stimulated HDL-cholesterol and specific food matrix factors. In addition, SFA are associated with the less atherogenic large buoyant LDL particles and possible counterbalancing hypotensive effects of dairy proteins. Overall, dairy foods have either a neutral or beneficial association with CVD and T2D. Beneficial associations are seen for blood pressure and the reduced T2D risk linked to yoghurt consumption, a subject that needs urgent attention given the sharp rise in T2D prevalence in many countries.
2型糖尿病（T2D）和心血管疾病（CVD）是导致死亡和慢性发病的主要原因。虽然心血管疾病导致的死亡率有所下降，但它们仍是欧洲最大的死因，且2型糖尿病的患病率正在迅速上升。公共卫生建议的一个一致内容是减少饱和脂肪酸（SFA）的摄入量，特别是为了降低心血管疾病风险，这意味着要限制乳制品的消费。本综述纳入的前瞻性研究和随机对照试验表明，至少对于乳制品来说，饱和脂肪酸与心血管疾病或2型糖尿病风险之间并无始终如一的关联。对于心血管疾病而言，尽管在许多饮食中乳制品是饱和脂肪酸的主要来源，但乳制品与之的关联总体上是中性的。这至少对乳制品而言，引发了人们对传统饮食-心脏假说有效性的严重质疑，该假说认为饱和脂肪酸摄入量与血清低密度脂蛋白胆固醇升高以及随后心血管疾病增加呈正相关。现在有新出现的证据来解释这一点，这与乳制品高度相关。这些证据包括饱和脂肪酸刺激高密度脂蛋白胆固醇的潜在抵消作用以及特定的食物基质因素。此外，饱和脂肪酸与致动脉粥样硬化性较低的大颗粒低密度脂蛋白有关，并且乳制品蛋白质可能具有抵消性的降压作用。总体而言，乳制品与心血管疾病和2型糖尿病的关联要么是中性的，要么是有益的。在血压以及与食用酸奶相关的2型糖尿病风险降低方面可以看到有益关联，鉴于许多国家2型糖尿病患病率急剧上升，这一主题需要紧急关注。
