代谢综合征是2型糖尿病和心血管疾病等慢性代谢性疾病的重要风险因素。近20年来,随着我国居民的膳食结构和生活方式的日渐西化,慢性代谢性疾病的患病率迅速上升。我国目前有超过有15.1% 成年人患有代谢综合征。因此,发现和建立经济有效的控制代谢综合征的方法是控制这类疾病的关键环节。
最近,美国《营养学杂志》(Journal of Nutrition)在线发表了由中科院上海生科院营养所林旭研究组与美国哈佛大学营养系Frank B. Hu教授合作完成的针对代谢综合征的营养干预研究成果。
亚麻子富含多不饱和(n-3)脂肪酸、木酚素和膳食纤维等营养成分。林旭研究组近年来已在亚麻子及其衍生物木酚素抗前列腺癌的机理和2型糖尿病干预方面取得了一系列重要进展。如发现亚麻子木酚素干预能显着地改善2型糖尿病患者的血糖控制和胰岛素抵抗(Pan et al. PLoS ONE, 2007),以及控制炎性因子C-反应蛋白水平(Pan et al. British Journal of Nutrition, 2008)。并通过对全球诸多的亚麻子干预进行荟萃分析发现:亚麻子干预能显着降低血液中总胆固醇和低密度脂蛋白胆固醇的水平(Pan et al. American Journal of Clinical Nutrition.2009).
核桃含有丰富的多不饱和脂肪酸、含精氨酸的植物蛋白,以及膳食纤维、叶酸、维生素E等多种营养成分。本研究的核桃干预部分是与哈佛大学营养系Frank B. Hu教授合作下进行的。Hu教授研究团队之前的研究发现核桃以及其它干果摄入对2型糖尿病、心血管疾病等慢性疾病具有保护作用;并通过荟萃分析发现富含核桃的膳食干预能显着降低血液中低密度脂蛋白胆固醇的水平(Banel et al. American Journal of Clinic Nutrition 2009)。
在该项目中,林旭研究组的博士生邬红玉等人采用平行设计方案,以美国心脏协会提出的指南为依据对代谢综合征患者或其高危个体(共计283名)进行健康生活方式教育。并在此基础上将他们随机分为(1)生活方式干预组(对照组):每天食用与干预组同等能量但不添加核桃或亚麻子的面包;(2)生活方式干预+亚麻子组:每天食用含有30克亚麻子的面包;(3)生活方式干预+核桃组:每天食用含有30克核桃的面包。经过为期12周的干预,结果发现:(1)与干预前相比,3组志愿者在干预后都显着降低了代谢综合征的患病率,有效地控制了体重和腰围并改善了血压、血糖和血脂水平;(2)与对照组相比,食物中添加亚麻子或核桃能显着提高腹型肥胖的逆转率;(3)亚麻子添加能显着降低腹型肥胖个体的空腹血糖;(4)核桃减轻了代谢综合征的严重程度(风险因子的数目)。该结果提示:低强度健康生活方式教育有助于代谢综合征的控制,而在此基础上添加富含亚麻子和核桃的食物能进一步改善腹型肥胖等代谢异常指标。本研究结果将为通过健康生活方式和饮食来控制代谢综合征提供新的思路和重要的科学依据。而且,我国是世界亚麻子和核桃的第二大生产国,该研究结果为我国现有植物资源的充分利用提供了实验依据。
该项目获得了中科院知识创新工程重大项目,中科院上海生科院首席科学家项目,国家自然科学基金和美国加州核桃协会基金联合资助。(生物谷Bioon.com)
生物谷推荐英文摘要:
J. Nutr. doi:10.3945/jn.110.126300
Lifestyle Counseling and Supplementation with Flaxseed or Walnuts Influence the Management of Metabolic Syndrome
Hongyu Wu5, An Pan6, Zhijie Yu5, Qibin Qi5, Ling Lu5, Geng Zhang5, Danxia Yu5, Geng Zong5, Yunhua Zhou5, Xiafei Chen7, Lixin Tang7, Ying Feng7, Hong Zhou8, Xiaolei Chen8, Huaixing Li5, Wendy Demark-Wahnefried9, Frank B. Hu6,10,11,* and Xu Lin5,*
A healthy lifestyle may ameliorate metabolic syndrome (MetS); however, it remains unclear if incorporating nuts or seeds into lifestyle counseling (LC) has additional benefit. A 3-arm, randomized, controlled trial was conducted among 283 participants screened for MetS using the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian Americans. Participants were assigned to a LC on the AHA guidelines, LC + flaxseed (30 g/d) (LCF), or LC + walnuts (30 g/d) (LCW) group. After the 12-wk intervention, the prevalence of MetS decreased significantly in all groups: –16.9% (LC), –20.2% (LCF), and –16.0% (LCW). The reversion rate of MetS, i.e. those no longer meeting the MetS criteria at 12 wk, was not significantly different among groups (LC group, 21.1%; LCF group, 26.6%; and LCW group, 25.5%). However, the reversion rate of central obesity was higher in the LCF (19.2%; P = 0.008) and LCW (16.0%; P = 0.04) groups than in the LC group (6.3%). Most of the metabolic variables (weight, waist circumference, serum glucose, total cholesterol, LDL cholesterol, apolipoprotein (Apo) B, ApoE, and blood pressure) were significantly reduced from baseline in all 3 groups. However, the severity of MetS, presented as the mean count of MetS components, was significantly reduced in the LCW group compared with the LC group among participants with confirmed MetS at baseline (P = 0.045). Our results suggest that a low-intensity lifestyle education program is effective in MetS management. Flaxseed and walnut supplementation may ameliorate central obesity. Further studies with larger sample sizes and of longer duration are needed to examine the role of these foods in the prevention and management of MetS.