Yu Junwen, Wu Yue, Zhu Zheng, Lu Hongzhou
School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, China.
Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, China.
Nutr J. 2025 Jan 28;24(1):17. doi: 10.1186/s12937-024-01060-x.
Previous studies found that it is promising to achieve the protective effects of dietary patterns on cardiovascular health through the modulation of gut microbiota. However, conflicting findings have been reported on how dietary patterns impact gut microbiota in individuals either established or at risk of cardiovascular disease (CVD). Our systematic review aimed to explore the effect of dietary patterns on gut microbiota composition and on risk factors for CVD in these populations.
We systematically searched seven databases, including PubMed/MEDLINE, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), Web of Science, CNKI (Chinese), and Wanfang (Chinese), covering literature from inception to October 2024. Studies were included if they focused on adults aged 18 years and older with CVD or at least two CVD risk factors, implemented dietary pattern interventions, and incorporated outcomes related to microbiome analysis. The risk of bias for included studies was assessed using the revised Cochrane risk of bias tool (RoB2) for randomized trials and the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) for non-randomized studies. Changes in the relative abundance of the gut microbiome were summarized at various taxonomic levels, including phylum, class, order, family, genus, and species. Random-effects meta-analysis was conducted to analyze the mean difference in cardiometabolic parameters pre- and post-intervention.
Nineteen studies were identified, including 17 RCT and two self-controlled trails. Risk of bias across the studies was mixed but mainly identified as low and unclear. The most frequently reported increased taxa were Faecalibacterium (N = 8) with plant-rich diets, Bacteroides (N = 3) with restrictive diets, and Ruminococcaceae UCG 005 and Alistipes (N = 9) with the polyphenol-rich diets. The most frequently reported decreased taxa were Parabacteroides (N = 7) with plant-rich diets, Roseburia (N = 3) with restrictive diets, and Ruminococcus gauvreauii group (N = 6) with the polyphenol-rich diets. Plant-rich diets showed a significant decrease in total cholesterol (TC) with a mean difference of -6.77 (95% CI, -12.36 to -2.58; I = 84.7%), while restrictive diets showed a significant decrease in triglycerides (TG) of -22.12 (95% CI, -36.05 to -8.19; I = 98.4%).
Different dietary patterns showed distinct impacts on gut microbiota composition. Plant-rich diets promoted the proliferation of butyrate-producing bacteria, suggesting promising prospects for modulating gut microbiota and butyrate production through dietary interventions to enhance cardiovascular health. Further research is warranted to investigate the long-term effects of dietary patterns on clinical endpoints, such as CVD events or mortality.
Registration number: CRD42024507660.
先前的研究发现，通过调节肠道微生物群来实现饮食模式对心血管健康的保护作用是有前景的。然而，关于饮食模式如何影响已患心血管疾病（CVD）或有CVD风险的个体的肠道微生物群，已有相互矛盾的研究结果报道。我们的系统评价旨在探讨饮食模式对这些人群肠道微生物群组成以及CVD风险因素的影响。
我们系统检索了7个数据库，包括PubMed/MEDLINE、MEDLINE（Ovid）、Embase（Ovid）、CINHAL（EBSCO）、Web of Science、CNKI（中文）和万方（中文），涵盖从创刊到2024年10月的文献。纳入的研究需聚焦于18岁及以上患有CVD或至少有两个CVD风险因素的成年人，实施饮食模式干预，并纳入与微生物组分析相关的结果。使用修订后的Cochrane偏倚风险工具（RoB2）评估随机试验纳入研究的偏倚风险，使用干预性非随机研究的偏倚风险（ROBINS-I）评估非随机研究的偏倚风险。在门、纲、目、科、属和种等不同分类水平上总结肠道微生物群相对丰度的变化。进行随机效应荟萃分析以分析干预前后心脏代谢参数的平均差异。
共纳入19项研究，包括17项随机对照试验和2项自身对照试验。各研究的偏倚风险不一，但主要为低风险和不明确风险。最常报道增加的分类群是富含植物的饮食组中的粪杆菌（N = 8）、限制饮食组中的拟杆菌（N = 3）以及富含多酚饮食组中的瘤胃球菌科UCG 005和阿里斯杆菌属（N = 9）。最常报道减少的分类群是富含植物的饮食组中的副拟杆菌属（N = 7）、限制饮食组中的罗斯氏菌属（N = 3）以及富含多酚饮食组中的戈氏瘤胃球菌群（N = 6）。富含植物的饮食组总胆固醇（TC）显著降低，平均差异为-6.77（95%CI，-12.36至-2.58；I² = 84.7%），而限制饮食组甘油三酯（TG）显著降低，为-22.12（95%CI，-36.05至-8.19；I² = 98.4%）。
不同的饮食模式对肠道微生物群组成有不同影响。富含植物的饮食促进了产丁酸细菌的增殖，这表明通过饮食干预调节肠道微生物群和丁酸生成以增强心血管健康具有广阔前景。有必要进一步研究饮食模式对临床终点（如CVD事件或死亡率）的长期影响。
注册号：CRD42024507660。
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