坚果和花生的食用与心血管疾病风险：随机对照试验的系统评价和荟萃分析。
Tree Nut and Peanut Consumption and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
机构信息
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
出版信息
Adv Nutr. 2023 Sep;14(5):1029-1049. doi: 10.1016/j.advnut.2023.05.004. Epub 2023 May 5.
Cardiovascular disease (CVD) is the leading cause of death globally. Habitual consumption of tree nuts and peanuts is associated with cardioprotective benefits. Food-based dietary guidelines globally recommend nuts as a key component of a healthy diet. This systematic review and meta-analysis were conducted to examine the relationship between tree nut and peanut consumption and risk factors for CVD in randomized controlled trials (RCTs) (PROSPERO: CRD42022309156). MEDLINE, PubMed, CINAHL, and Cochrane Central databases were searched up to 26 September, 2021. All RCT studies that assessed the effects of tree nut or peanut consumption of any dose on CVD risk factors were included. Review Manager software was used to conduct a random effect meta-analysis for CVD outcomes from RCTs. Forest plots were generated for each outcome, between-study heterogeneity was estimated using the I test statistic and funnel plots and Egger's test for outcomes with ≥10 strata. The quality assessment used the Health Canada Quality Appraisal Tool, and the certainty of the evidence was assessed using grading of recommendations assessment, development, and evaluation (GRADE). A total of 153 articles describing 139 studies (81 parallel design and 58 cross-over design) were included in the systematic review, with 129 studies in the meta-analysis. The meta-analysis showed a significant decrease for low-density lipoprotein (LDL) cholesterol, total cholesterol (TC), triglycerides (TG), TC:high-density lipoprotein (HDL) cholesterol, LDL cholesterol:HDL cholesterol, and apolipoprotein B (apoB) following nut consumption. However, the quality of evidence was "low" for only 18 intervention studies. The certainty of the body of evidence for TC:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apoB were "moderate" because of inconsistency, for TG were "low," and for LDL cholesterol and TC were "very low" because of inconsistency and the likelihood of publication bias. The findings of this review provide evidence of a combined effect of tree nuts and peanuts on a range of biomarkers to create an overall CVD risk reduction.
心血管疾病（CVD）是全球范围内的主要死因。习惯性食用树坚果和花生与心脏保护益处有关。全球的基于食物的膳食指南建议坚果作为健康饮食的关键组成部分。本系统评价和荟萃分析旨在检查随机对照试验（RCT）中树坚果和花生消费与 CVD 危险因素之间的关系（PROSPERO：CRD42022309156）。截至 2021 年 9 月 26 日，检索了 MEDLINE、PubMed、CINAHL 和 Cochrane Central 数据库。纳入了评估任何剂量的树坚果或花生消费对 CVD 危险因素影响的所有 RCT 研究。使用 Review Manager 软件对 RCT 中的 CVD 结局进行随机效应荟萃分析。为每个结局生成森林图，使用 I 检验统计量和漏斗图以及 Egger 检验评估研究间异质性对于有≥10 个分层的结局。使用加拿大卫生部质量评估工具进行质量评估，使用推荐评估、制定和评价（GRADE）对证据的确定性进行评估。系统评价共纳入 153 篇描述 139 项研究（81 项平行设计和 58 项交叉设计）的文章，荟萃分析纳入 129 项研究。荟萃分析显示，坚果消费后低密度脂蛋白（LDL）胆固醇、总胆固醇（TC）、甘油三酯（TG）、TC：高密度脂蛋白（HDL）胆固醇、LDL 胆固醇：HDL 胆固醇和载脂蛋白 B（apoB）显著降低。然而，仅 18 项干预研究的证据质量为“低”。由于不一致，TC：HDL 胆固醇、LDL 胆固醇：HDL 胆固醇和 apoB 的证据体确定性为“中度”，由于不一致和发表偏倚的可能性，TG 的确定性为“低”，而 LDL 胆固醇和 TC 的确定性为“非常低”。本综述的研究结果提供了树坚果和花生对一系列生物标志物的综合影响，从而降低整体 CVD 风险的证据。
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