Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Scientific Society for Vegetarian Nutrition - SSNV, Venice (VE), Italy.
Nutr Metab Cardiovasc Dis. 2023 Jul;33(7):1308-1315. doi: 10.1016/j.numecd.2023.04.005. Epub 2023 Apr 13.
A comprehensive review comparing the effect of vegetarian (V) and non-vegetarian (NV) diets on the major cardiometabolic diseases' outcomes was performed.
We performed literature research (up to December 31, 2022) of the evidence separately for vascular disease (VD), obesity (OB), dyslipidemia (Dysl), hypertension (HPT), type 2 diabetes (T2D), metabolic syndrome (MetS), analyzing only cohort studies and randomized controlled studies (RCTs) and comparing the effect of V and NV diets. Cohort studies showed advantages of V diets compared to NV diets on incidence and/or mortality risk for ischemic heart disease, overweight and OB risk. Most cohort studies showed V had lower risk of HPT and lower blood pressure (BP) than NV and V diets had positive effects on T2D risk or plasma parameters. The few cohort studies on the risk of MetS reported mixed results. In RCTs, V diets, mainly low-fat-vegan ones, led to greater weight loss and improved glycemic control than NV diets and in the only one RCT a partial regression of coronary atherosclerosis. In most RCTs, V diets significantly reduced LDL-C levels (but also decreased HDL-C levels) and BP.
In this comprehensive review of the association between V diets and cardiometabolic outcomes, we found that following this type of diet may help to prevent most of these diseases. However, the non-uniformity of the studies, due to ethnic, cultural, and methodological differences, does not allow for generalizing the present results and drawing definitive conclusions. Further, well-designed studies are warranted to confirm the consistency of our conclusions.
对比较素食(V)和非素食(NV)饮食对主要心血管代谢疾病结局影响的研究进行综合回顾。
我们对血管疾病(VD)、肥胖(OB)、血脂异常(Dysl)、高血压(HPT)、2 型糖尿病(T2D)、代谢综合征(MetS)的证据分别进行了文献研究(截至 2022 年 12 月 31 日),仅分析了队列研究和随机对照研究(RCT),并比较了 V 和 NV 饮食的影响。队列研究表明,与 NV 饮食相比,V 饮食在缺血性心脏病、超重和 OB 风险的发生率和/或死亡率方面具有优势。大多数队列研究表明,V 饮食比 NV 饮食具有更低的 HPT 和血压风险,并且对 T2D 风险或血浆参数具有积极影响。少数关于 MetS 风险的队列研究报告了混合结果。在 RCT 中,V 饮食,主要是低脂肪素食,比 NV 饮食导致更大的体重减轻和改善血糖控制,并且在唯一一项 RCT 中部分逆转了冠状动脉粥样硬化。在大多数 RCT 中,V 饮食显著降低 LDL-C 水平(但也降低了 HDL-C 水平)和血压。
在这项关于 V 饮食与心血管代谢结局之间关系的综合回顾中,我们发现遵循这种饮食方式可能有助于预防大多数这些疾病。然而,由于种族、文化和方法学差异,研究的非一致性不允许对目前的结果进行概括并得出明确的结论。进一步需要进行精心设计的研究来证实我们结论的一致性。