Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts
Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts
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DOI：
10.1093/advances/nmz069
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发表时间：
2019-09-01
影响因子：
9.3
通讯作者：
Magkos, Faidon
中科院分区：
文献类型：
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作者：
Astrup, Arne;Geiker, Nina Rica Wium;Magkos, Faidon
目前限制饱和脂肪摄入量的饮食建议主要基于早期营养研究，这些研究表明饮食饱和脂肪，血液胆固醇水平升高和心血管疾病风险增加之间存在直接联系。由于全脂奶制品含有丰富的饱和脂肪，这些膳食指南建议食用无脂肪或低脂奶制品以代替全脂奶制品。然而，乳制品在营养成分和生物活性成分方面差异很大，研究越来越强调关注全食品的重要性（即，食物基质），而不是单一的营养素，如饱和脂肪。事实上，最近的大型和良好对照的研究，系统评价和观察性研究和随机对照试验的荟萃分析的证据表明，全脂乳制品，特别是酸奶和奶酪，不会对胰岛素敏感性，血脂谱和血压产生有害影响，如以前根据其钠和饱和脂肪含量预测的那样;它们不会增加心血管代谢疾病的风险，事实上可以预防心血管疾病和2型糖尿病。尽管需要进行更多的研究来调整可能的混杂因素，并更好地了解乳制品对健康结果的作用机制，但越来越清楚的是，限制膳食饱和脂肪以降低心脏代谢疾病风险的建议已经过时。因此，从饮食中限制或消除全脂乳制品的建议可能不是降低心脏代谢疾病风险的最佳策略，应该根据最近的证据重新评估。
Current dietary recommendations to limit consumption of saturated fat are largely based on early nutrition studies demonstrating a direct link between dietary saturated fat, elevated blood cholesterol levels, and increased risk of cardiovascular disease. As full-fat dairy products are rich in saturated fat, these dietary guidelines recommend consumption of fat-free or low-fat dairy products in place of full-fat dairy. However, dairy products vary greatly in both their nutrient content and their bioactive ingredients, and research increasingly highlights the importance of focusing on whole foods (i.e., the food matrix) as opposed to single nutrients, such as saturated fat. In fact, the weight of evidence from recent large and well-controlled studies, systematic reviews, and meta-analyses of both observational studies and randomized controlled trials indicates that full-fat dairy products, particularly yogurt and cheese, do not exert the detrimental effects on insulin sensitivity, blood lipid profile, and blood pressure as previously predicted on the basis of their sodium and saturated fat contents; they do not increase cardiometabolic disease risk and may in fact protect against cardiovascular disease and type 2 diabetes. Although more research is warranted to adjust for possible confounding factors and to better understand the mechanisms of action of dairy products on health outcomes, it becomes increasingly clear that the recommendation to restrict dietary saturated fat to reduce risk of cardiometabolic disease is getting outdated. Therefore, the suggestion to restrict or eliminate full-fat dairy from the diet may not be the optimal strategy for reducing cardiometabolic disease risk and should be re-evaluated in light of recent evidence.