Mekki N, Dubois C, Charbonnier M, Cara L, Senft M, Pauli A M, Portugal H, Gassin A L, Lafont H, Lairon D
Unité 130-INSERM (National Institute of Health and Medical Research), Laboratoire Central d'Analyse, Hôpital Ste Marguerite, Marseille, France.
Am J Clin Nutr. 1997 Dec;66(6):1443-51. doi: 10.1093/ajcn/66.6.1443.
The aim of this study was to evaluate the cholesterol-lowering effects of reducing fat and increasing or not increasing dietary fiber in subjects consuming a mixed Mediterranean-Western diet. Thirty-one free-living, mildly hypercholesterolemic subjects were randomly allocated to two groups. Subjects in both groups first shifted for 4 wk to a low-fat, low-fiber diet (LFLFD). For an additional 4-wk period, subjects in group 1 continued consuming the LFLFD whereas subjects in group 2 consumed a low-fat, high-fiber diet (LFHFD). Most dietary fatty acids were monounsaturated (38-41%) and fibers, when provided (up to 35 g/d), came from unrefined cereals, legumes, and soluble-fiber-enriched ready-to-eat cereals. After period 1 of the LFLFD, mean serum and low-density-lipoprotein (LDL)-cholesterol concentrations of subjects in groups 1 (-12.5% and -15.5%, respectively) and 2 (-10.5% and -15.5%, respectively) decreased significantly from baseline (P < 0.05). After period 2, mean serum and LDL-cholesterol concentrations of subjects consuming the LFLFD (group 1) were still lower (by 8.8% and 9.2%, respectively, from baseline) whereas in subjects consuming the LFHFD (group 2) these values decreased further to significantly lower values (14.2% and 17.6% from baseline, respectively). Fasting high-density-lipoprotein (HDL) cholesterol, apolipoprotein A-I, glycemia, and insulinemia did not change significantly. In seven men, postprandial lipemia transiently increased more after a breakfast test meal at the completion of the LFHFD period than after the LFLFD period. In conclusion, an LFHFD more comparable with the traditional Mediterranean diet may improve the dietary management of moderate hypercholesterolemia.
本研究的目的是评估在食用混合地中海 - 西方饮食的受试者中，减少脂肪并增加或不增加膳食纤维的降胆固醇效果。31名自由生活的轻度高胆固醇血症受试者被随机分为两组。两组受试者首先转换为低脂肪、低纤维饮食（LFLFD），持续4周。在接下来的4周期间，第1组受试者继续食用LFLFD，而第2组受试者食用低脂肪、高纤维饮食（LFHFD）。大多数膳食脂肪酸为单不饱和脂肪酸（38 - 41%），所提供的纤维（高达35克/天）来自未精制谷物、豆类和富含可溶性纤维的即食谷物。在LFLFD的第1阶段后，第1组（分别降低12.5%和15.5%）和第2组（分别降低10.5%和15.5%）受试者的平均血清和低密度脂蛋白（LDL）胆固醇浓度较基线水平显著降低（P < 0.05）。在第2阶段后，食用LFLFD的第1组受试者的平均血清和LDL胆固醇浓度仍较低（分别比基线水平低8.8%和9.2%），而食用LFHFD的第2组受试者的这些值进一步降至显著更低水平（分别比基线水平低14.2%和17.6%）。空腹高密度脂蛋白（HDL）胆固醇、载脂蛋白A - I、血糖和胰岛素血症无显著变化。在7名男性中，LFHFD阶段结束后早餐试验餐后的餐后血脂较LFLFD阶段结束后短暂升高更多。总之，与传统地中海饮食更相似的LFHFD可能改善中度高胆固醇血症的饮食管理。
