Singh R B, Rastogi V, Rastogi S S, Niaz M A, Beegom R
Heart Research Laboratory, Medical Hospital and Research Centre, Moradabad, India.
J Am Coll Nutr. 1996 Dec;15(6):592-601. doi: 10.1080/07315724.1996.10718635.
To test whether a fat modified and fruit and vegetable enriched diet in conjunction with moderate physical activity reduces the cardiac event rate in patients with coronary artery disease (CAD) and its risk factors in an urban setting in India.
480 patients either with CAD or with risk factors. Those with definite or possible CAD including angina pectoris (n = 210) based on World Health Organization criteria and patients with risk factors were assigned to diet A (n = 231) or diet B (n = 232) for a period of 3 years. Both groups were advised to follow a fat modified diet. Group A was also advised to consume at least 400 g/day of fruits, vegetables and legumes according to World Health Organization advice and include moderate physical activity.
Waist-hip ratios, fasting and post-prandial blood glucose, plasma insulin levels, blood pressure and weight fell significantly in patients in group A compared with those in group B. While triglycerides in group A showed a significant decrease, high density lipoprotein cholesterol showed a significant increase. Both groups showed a significant reduction in total and low density lipoprotein cholesterol, although the decrease was greater in group A than group B. Central obesity decreased by 6.2% in group A vs. 1.2% in group B, 95% confidence interval of difference 2.3 to 7.8. The incidence of cardiac events was significantly lower in group A than group B (29 vs. 43 patients, p < 0.01). All-cause mortality also significantly declined in group A compared with group B (16 vs. 24 died, p < 0.05). The group A patients with better adherence to exercise and diet showed greater reduction in central obesity and greater decline in cardiac event rates and total mortality compared to control group B.
It is possible that moderate physical activity in conjunction with dietary changes in patients with CAD may cause substantial reductions in central obesity and associated disturbances corresponding to a significant decrease in cardiac events and mortality during the follow-up of 3 years.
在印度城市环境中，测试富含水果、蔬菜且脂肪改良的饮食，结合适度体育活动，是否能降低冠心病（CAD）患者及其危险因素患者的心脏事件发生率。
480例患有CAD或具有危险因素的患者。根据世界卫生组织标准，确诊或可能患有CAD（包括心绞痛，n = 210）的患者以及具有危险因素的患者被分配至饮食A组（n = 231）或饮食B组（n = 232），为期3年。两组均被建议遵循脂肪改良饮食。A组还被建议根据世界卫生组织的建议，每天至少摄入400克水果、蔬菜和豆类，并进行适度体育活动。
与B组相比，A组患者的腰臀比、空腹和餐后血糖、血浆胰岛素水平、血压和体重显著下降。A组甘油三酯显著降低，而高密度脂蛋白胆固醇显著升高。两组的总胆固醇和低密度脂蛋白胆固醇均显著降低，尽管A组的降低幅度大于B组。A组中心性肥胖下降了6.2%，而B组下降了1.2%，差异的95%置信区间为2.3至7.8。A组心脏事件的发生率显著低于B组（29例对43例患者，p < 0.01）。与B组相比，A组的全因死亡率也显著下降（16例死亡对24例死亡，p < 0.05）。与对照组B相比，A组中更好地坚持运动和饮食的患者中心性肥胖的减少幅度更大，心脏事件发生率和总死亡率的下降幅度也更大。
CAD患者适度体育活动结合饮食改变，可能会在3年随访期间使中心性肥胖及相关紊乱大幅减少，相应地使心脏事件和死亡率显著降低。
