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医学翻译——脂肪和CVD,B族维生素与CVD

发布者:鑫达医学翻译 发布时间:2013-06-01 8:50:52 阅读:

原文:

Until 1990s, it was recommended to limit total fat intake to reduce CVD risk. A 2009 meta-analysis of prospective studies and Women’s Health Initiative Dietary Modification Trial showed that total fat was not associated with CVD incidence.

AHA (2006) recommends that limiting saturated fat to <7% energy and trans fat to <1% energy to reduce CVD risk. Dietary Guidelines for Americans (2010) recommends that saturated fat intake should be <7%, with replacement with MUFA and PUFA.

The cardio-protective benefit of marine n-3 PUFA (EPA and DHA) is established, but the evidence for plant-derived n-3 PUFA (mainly ALA) is limited. 

 

Homocysteine, a product of demethylation of methionine, is associated with increased risk of CVD. Each 5 μmol/L is associated with 20% increased risk of CVD

Evidence for a link between B vitamins (folate, B6, B12) and CVD comes from the homocysteine-lowering effect of these vitamins. 

Epidemiologic studies have shown that dietary intake, or blood levels, of B vitamins are inversely associated with CVD events and mortality. 

However, most of the clinical trials of supplementation with folate and other B vitamins have not shown a protective effect in reducing CVD risk. Possible reasons: different populations (at baseline, more healthy vs. more pre-existing CVD; CVD patients use more B vitamins); most RCTs were conducted after U.S. fortificaiton of all grain product with folic acid.     

 

 

译文:

20世纪90年代前,建议通过限制脂肪摄入总量来降低CVD风险。但2009年开展的一项前瞻性meta分析和一项针对女性低脂膳食的调查结果显示,摄入脂肪总量与CVD发病率无关。

AHA(2006)建议将饱和脂肪限制在摄入总能量的7%以内,反式脂肪占总能量的1%以上,从而降低患CVD的危险。美国膳食指南(2010版)建议饱和脂肪摄入量应低于7%,用单不饱和脂肪酸(MUFA)和多不饱和脂肪酸(PUFA)来代替饱和脂肪。

已经确定海洋ω -3 PUFA (EPA 和 DHA)对心脏具保护作用,但是源于植物的ω -3 PUFA (主要是ALA)的作用还不是很明确。

 

甲硫氨酸去甲基化产物高半胱氨酸与患CVD风险增加相关。含量每增加5 umol/L,患CVD的风险将增加20%。

B族维生素(叶酸、B6、B12)和CVD相关的证据来自该类维生素可降低高半胱氨酸浓度。

流行病学研究显示,B族维生素的膳食摄入量或其在血液中的含量与CVD患病和死亡率呈负相关。

然而,大部分补充叶酸和其他B族维生素的临床试验都未能证实可降低CVD风险。原因可能在于:纳入群体不同(基准线不同,需要更多的研究对照与受试者;CVD患者使用更多的B族维生素);大部分随机对照试验是在美国强化所有谷类产品中叶酸含量后进行的,不能排除对照组与试验组通过饮食纳入大量叶酸对研究的影响)。

 

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