心脏健康膳食干预对上海地区心血管疾病高风险人群血压和氧化应激指标的影响

Effects of heart⁃healthy dietary intervention on blood pressure and oxidative stress in high⁃risk population of cardi⁃ovascular disease in Shanghai

目的观察心脏健康膳食干预对心血管疾病高风险人群的血压、氧化应激指标的影响。方法在上海地区招募符合条件的心血管疾病高风险受试者71例,简单随机抽样分入对照组与干预组,进行全程膳食管理干预。干预组给予心脏健康膳食,特点为增加全谷物摄入量,保证新鲜蔬菜和水果充足摄入,动物性食物多鱼虾少猪肉,增加奶制品摄入,烹调清淡少油少盐,使用高钾低钠盐。对照组给予符合上海地区饮食习惯的常规膳食。试验先经过一周的导入期,随后进入四周的试验期。结果经过心脏健康膳食干预后,干预组每日盐[(5.21±0.04)vs(10.75±0.10)g]、食用油[(20.96±0.13)vs(37.46±0.98)g]和畜禽肉类摄入量低于对照组,大豆及坚果类、鱼虾类和蔬菜类摄入量高于对照组(P<0.05)。营养素分析显示,干预组的蛋白质、碳水化合物、膳食纤维、钾、钙和镁摄入量高于对照组,而脂肪、胆固醇和钠摄入量低于对照组(P<0.05)。干预组收缩压下降(20.1±1.1)mmHg,舒张压下降(9.4±0.8)mmHg,与对照组相比,平均收缩压多下降13.4mmHg,平均舒张压较多下降5.8mmHg,差异均有统计学意义(P<0.05)。干预前后干预组血清丙二醛含量降低1.35nmol/L,谷胱甘肽和超氧化物歧化酶分别上升1.85μmol/L和13.75U/mL,与对照组干预前后变化值相比,差异有统计学意义(P<0.05)。结论心脏健康膳食可以降低心血管疾病高风险人群的血压,同时改善其氧化应激状态。

Objective To observe the effects of heart-healthy dietary intervention on blood pressure and oxidative stress indexes in people at high risk of cardiovascular disease.Methods 71eligible subjects at high risk of cardiovascular disease were recruited in Shanghai area.They were randomly divided into control group and intervention group and all subjects received a full-meal dietary intervention.The intervention group was given a heart-healthy diet,which was characterized by increasing the intake of whole grains,ensuring adequate intake of fresh vegetables and fruits,animal food with more fish,shrimp and less pork,increasing the intake of dairy products,light cooking,less oil and salt,and using high potassium and low sodium salt.The control group was given a routine diet in line with the dietary habits of Shanghai area.After a one-week run-in period,the trial was followed by a four-week trial period.Results After heart-healthy dietary intervention,the daily intake of salt[(5.21±0.04)vs(10.75±0.10)g],edible oil[(20.96±0.13)vs(37.46±0.98)g]and livestock and poultry meat in the intervention group was lower than that in the control group,and the intake of soybeans,nuts,fish,shrimp and vegetables in the intervention group was higher than that in the control group(P<0.05).The nutrient analysis showed that the intake of protein,carbohydrate,dietary fiber,potassium,calcium and magnesium in the intervention group was higher than that in the control group,while the intake of fat,cholesterol and sodium was lower than that in the control group(P<0.05).In the intervention group,systolic blood pressure decreased by(20.1±1.1)mmHg and diastolic blood pressure decreased by(9.4±0.8)mmHg.Compared with the control group,the average systolic blood pressure of the intervention group decreased by 13.4mmHg,and the average diastolic blood pressure decreased by5.8mmHg,the differences were statistically significant(P<0.05).After the intervention,the serum malondialdehyde content of the intervention group decreased by1.35nmol/L,and the contents of glutathione and superoxide dismutase increased by 1.85μmol/L and 13.75U/mL,respectively.Compared with the change value of the control group before and after intervention,the differences were statistically significant(P<0.05).Conclusion A heart-healthy diet can reduce blood pressure and improve oxidative stress status in people at high risk of cardiovascular disease.