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| 購買進口儀器、試劑和耗材——就在始于2001年的畢特博生物 www.mobfastly.com |
提到降低膽固醇的方法，人們通常會想到服用他汀類藥物和避免油膩飲食。加拿大研究人員說，只要建立良好飲食習慣，加上有助降低膽固醇的食物，膽固醇水平稍高的人士甚至無需服藥。 這一研究結果8月23日由《美國醫學會雜志》（JAMA）發表。 六月實驗 多倫多大學戴維·詹金斯與同事找來351名志愿者，這些人年齡在五十歲上下，膽固醇水平高，平時只吃素。一些人正在服用他汀類藥物。 研究人員把志愿者隨機分成三組，進行為期六個月的研究。一組人在這期間堅持低脂飲食，另外兩組人在營養師指導下多吃有助降低膽固醇的食物，如豆奶、豆腐、堅果、燕麥、豌豆和各種豆類。 營養師建議后兩組志愿者每攝取1000卡路里熱量就通過植物黃油攝取1克植物固醇，同時還要通過吃麥片、大麥和亞麻籽攝入10克纖維再加上22.5克大豆蛋白和22.5克堅果。 后兩組人中，一組人在研究期間接受兩次專家指導，另一組接受七次。 研究期間，所有服用他汀類藥物的志愿者暫停用藥。 效果明顯 研究結果顯示，六個月后，第一組志愿者體內有害的低密度脂蛋白膽固醇（LDL-C)水平平均下降3%。吃降膽固醇食物的志愿者中，接受兩次指導的志愿者LDL-C水平平均下降13%，接受七次的下降13.8%。 從數值來看，研究開始前，志愿者的平均LDL-C數值為170mg/dL。一般來說，LDL-C數值達到160mg/dL就被視為過高。 實驗結束時，第一組志愿者LDL-C平均降低8mg/dL，后兩組分別降低24mg/dL和26mg/dL，達到正常標準。 英國心臟基金會高級心臟健康營養學家維多利亞·泰勒說：“研究結果令人鼓舞。” 美國全國心、肺、血液研究所說，LDL-C之所以引人關注，是因為這種膽固醇會在血管壁上累積，大大增加患心臟病和中風的幾率。 注意飲食 “毫無疑問，他汀類藥物在防治心血管疾病方面起到重要作用，”路透社23日引述詹金斯的話報道，“但至少到目前為止，他汀類藥物作用有限……實際上，飲食具有強大力量。” 研究人員指出，所有志愿者原本就為降低膽固醇水平控制飲食，飲食健康水平高于一般人群平均值，這是食用降膽固醇食物能取得明顯效果的前提。 “如果你想坐在沙發上大吃大喝，看著別人運動而自己無動于衷，那你還是適合靠服用藥物來降低膽固醇，”詹金斯說。 美國洛馬琳達大學營養學專家瓊·薩巴特提醒，利用食物調節LDL-C水平的方法對那些膽固醇水平超過正常值太多的人并不適用，這些人還是需要依靠藥物進行調節。
doi:10.1001/jama.2011.1202 Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia David J. A. Jenkins, MD;Peter J. H. Jones, PhD;Benoit Lamarche, PhD;Cyril W. C. Kendall, PhD;Dorothea Faulkner, PhD;Luba Cermakova MSc;Iris Gigleux, MSc;Vanu Ramprasath, PhD;Russell de Souza, SD;Chris Ireland, BSc;Darshna Patel, BA;Korbua Srichaikul, MSc;Shahad Abdulnour, MSc;Balachandran Bashyam, PhD;Cheryl Collier, MSc;Sandy Hoshizaki, BSc;Robert G. Josse, MD;Lawrence A. Leiter, MD;Philip W. Connelly, PhD;Jiri Frohlich, MD Context Combining foods with recognized cholesterol-lowering properties (dietary portfolio) has proven highly effective in loweringserum cholesterol under metabolically controlled conditions.Objective To assess the effect of a dietary portfolio administered at 2 levels of intensity on percentage change in low-density lipoproteincholesterol (LDL-C) among participants following self-selected diets.Design, Setting, and Participants A parallel-design study of 351 participants with hyperlipidemia from 4 participating academic centers across Canada (QuebecCity, Toronto, Winnipeg, and Vancouver) randomized between June 25, 2007, and February 19, 2009, to 1 of 3 treatments lasting6 months.Intervention Participants received dietary advice for 6 months on either a low? saturated fat therapeutic diet (control) or a dietaryportfolio, for which counseling was delivered at different frequencies, that emphasized dietary incorporation of plant sterols,soy protein, viscous fibers, and nuts. Routine dietary portfolio involved 2 clinic visits over 6 months and intensive dietaryportfolio involved 7 clinic visits over 6 months.Main Outcome Measures Percentage change in serum LDL-C.Results In the modified intention-to-treat analysis of 345 participants, the overall attrition rate was not significantly differentbetween treatments (18% for intensive dietary portfolio, 23% for routine dietary portfolio, and 26% for control; Fisher exacttest, P = .33). The LDL-C reductions from an overall mean of 171 mg/dL (95% confidence interval [CI], 168-174 mg/dL) were ?13.8%(95% CI, ?17.2% to ?10.3%; P < .001) or ?26 mg/dL (95% CI, ?31 to ?21 mg/dL; P < .001) for the intensive dietary portfolio; ?13.1% (95% CI, ?16.7% to ?9.5%; P < .001) or –24 mg/dL (95% CI, ?30 to ?19 mg/dL; P < .001) for the routine dietary portfolio; and ?3.0% (95% CI, ?6.1% to 0.1%; P = .06) or ?8 mg/dL (95% CI, ?13 to ?3 mg/dL; P = .002) for the control diet. Percentage LDL-C reductions for each dietary portfolio were significantly more than the controldiet (P < .001, respectively). The 2 dietary portfolio interventions did not differ significantly (P = .66). Among participants randomized to one of the dietary portfolio interventions, percentage reduction in LDL-C on thedietary portfolio was associated with dietary adherence (r = ?0.34, n = 157, P < .001).Conclusion Use of a dietary portfolio compared with the low?saturated fat dietary advice resulted in greater LDL-C lowering during 6months of follow-up.Trial Registration clinicaltrials.gov Identifier: NCT00438425 |
購買進口儀器、試劑和耗材——就在始于2001年的畢特博生物
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