Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein
Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein
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DOI：
10.1001/jama.290.4.502
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发表时间：
2003-07-23
影响因子：
120.7
通讯作者：
Connelly, PW
中科院分区：
文献类型：
--
作者：
Jenkins, DJA;Kendall, CWC;Connelly, PW
背景：为了提高饮食在降低胆固醇方面的有效性，国家胆固醇教育计划成人治疗小组III的建议强调低饱和脂肪、植物固醇和粘性纤维的饮食，美国心脏协会支持使用大豆蛋白和坚果。目的确定含有所有这些推荐食物成分的饮食是否能与3-羟基-3-甲基戊二酰辅酶a还原酶抑制剂（他汀类药物）相比降低胆固醇。设计2002年10月至12月进行随机对照试验。背景和参与者从加拿大医院附属营养研究中心和社区招募了46名健康的高脂血症成年人（25名男性和21名绝经后女性），平均（SE）年龄为59(1)岁，体重指数为27.6（0.5）。干预措施参与者被随机分配在门诊基础上接受3种干预措施中的1种，为期1个月：饱和脂肪含量极低的饮食，以全麦谷物和低脂乳制品为基础（n=16；对照组）；同样的饮食加洛伐他汀，20mg /d (n = 14)；或者饮食中富含植物固醇（1.0克/1000千卡）、大豆蛋白（21.4克/1000千卡）、粘性纤维（9.8克/1000千卡）和杏仁（14克/1000千卡）（n=16；饮食组合）。血脂和c反应蛋白水平，取自空腹血液样本；血压;体重；在第0、2和4周进行测量，并在3个治疗组之间进行比较。结果对照组、他汀类药物组和饮食组合组低密度脂蛋白胆固醇平均（SE）降低8.0% (2.1%)（P= 0.002）、30.9% (3.6%)（P= 0.002）
Context To enhance the effectiveness of diet in lowering cholesterol, recommendations of the Adult Treatment Panel III of the National Cholesterol Education Program emphasize diets low in saturated fat together with plant sterols and viscous fibers, and the American Heart Association supports the use of soy protein and nuts.Objective To determine whether a diet containing all of these recommended food components leads to cholesterol reduction comparable with that of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins).Design Randomized controlled trial conducted between October and December 2002.Setting and Participants Forty-six healthy, hyperlipidemic adults (25 men and 21 postmenopausal women) with a mean (SE) age of 59 (1) years and body mass index of 27.6 (0.5), recruited from a Canadian hospital-affiliated nutrition research center and the community.Interventions Participants were randomly assigned to undergo 1 of 3 interventions on an outpatient basis for 1 month: a diet very low in saturated fat, based on milled whole-wheat cereals and low-fat dairy foods (n=16; control); the same diet plus lovastatin, 20 mg/d (n = 14); or a diet high in plant sterols (1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers (9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (n=16; dietary portfolio).Main Outcome Measures Lipid and C-reactive protein levels, obtained from fasting blood samples; blood pressure; and body weight; measured at weeks 0, 2, and 4 and compared among the 3 treatment groups.Results The control, statin, and dietary portfolio groups had mean (SE) decreases in low-density lipoprotein cholesterol of 8.0% (2.1%) (P=.002), 30.9% (3.6%) (P