膳食模式对人体免疫功能的影响

Influence of dietary pattern on human immunity

目的系统分析膳食模式与人体免疫水平和健康状况的关系。方法以膳食模式、膳食结构、营养素、食物、蛋白质、脂肪、维生素、膳食纤维、炎症、炎性、氧化应激、免疫力、免疫为中文检索词,dietary、nutrition、nutrients、food、diet、vitamin、immune、immunity、inflammatory、inflammation、oxidative stress为英文检索词进行逻辑组合,系统检索万方、中国知网(CNKI)、Web of Science、PubMed等数据库从收录起始日期至2020年1月10日相关文献,逐步筛选后进行归纳探讨。结果共纳入1篇中文文献和22篇英文文献,其中横断面研究9篇、干预性研究7篇、队列研究6篇以及巢式病例对照研究1篇。膳食模式常见的评价方法有膳食炎症指数(DII)、膳食炎症评分(ISD)、经验性饮食炎症模式评分(EDIP)、膳食依从性评分和健康饮食指数。地中海膳食模式和以蔬菜、水果、豆制品、鱼和奶制品摄入较高的健康膳食模式研究较多,共13篇。地中海膳食模式可降低C反应蛋白(CRP)、白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)、白细胞计数(WBC)和纤维蛋白原等炎症标志物,以及血管内皮生长因子、内皮功能评分等代谢性指标水平,改善慢性炎症性疾病,降低慢性病发生风险。健康膳食评分越高,促炎因子水平越低,即使未达到膳食推荐量,其饮食越健康,炎症因子水平越低。西方膳食模式可增加CRP、IL-6、E-选择素、黏附分子1(sICAM-1)和可溶性血管细胞黏附分子1(sVCAM-1)等炎症因子浓度,以及2型糖尿病发病率和心血管疾病风险,但也有1研究未发现其与炎症标志物高敏C反应蛋白的关系。结论膳食模式与人体免疫功能密切相关,不同膳食模式根据食物摄入特征具有不同的炎症潜力,可直接或间接地影响免疫功能。

Objective To systematically review the relationship between dietary patterns and human immunity and health.Methods Chinese and English search terms,including"dietary pattern","dietary structure","nutrients","food","protein","fat","vitamins","dietary fiber","immunity","inflammatory","inflammation","oxidative stress",were searched for relevant articles in PubMed,Web of Science,Wanfang and National Knowledge Infrastructure(CNKI)database from the collection start date to January 10,2020.Results A total of 1 Chinese article and 22 English articles were included,including 9 cross-sectional studies,7 intervention studies,6 cohort studies and 1 nested case-control study.Common evaluation methods for dietary patterns included dietary inflammatory index(DII),inflammatory score of the diet(ISD),empirical dietary inflammatory pattern(EDIP),dietary compliance score,and healthy eating index.There were 13 studies on Mediterranean dietary patterns and healthy dietary patterns with higher intake of vegetables,fruits,bean products,fish and dairy products in the included articles.The Mediterranean diet can reduce the levels of inflammatory markers such as CRP,IL-6,Hcy,WBC,and fibrinogen,as well as the levels of metabolic indicators such as vascular endothelial growth factor and endothelial function score,improve chronic inflammatory diseases and reduce the risk of chronic diseases.The higher the healthy diet score was,the lower the level of pro-inflammatory factors was.Even if the dietary recommendation was not met,the healthier the diet was,the lower the level of inflammatory factors was.Western dietary patterns were positively correlated with CRP,IL-6,E-selectin,sICAM-1,sVCAM-1 and other inflammatory factors,and can increase the incidence of type 2 diabetes and the risk of cardiovascular disease.However,one study did not found the relationship between them and hs-CRP.Conclusions Dietary patterns are closely related to human immune function.Different dietary patterns have different inflammatory potentials according to the characteristics of food intake,which can directly or indirectly affect immune function.