当前位置:科学网首页 > 小柯机器人 >详情
地中海饮食对心血管疾病的长期二级预防效果优于低脂饮食
作者:小柯机器人 发布时间:2022/5/8 22:05:23

西班牙雷纳索非亚大学医院Jose Lopez-Miranda、Javier Delgado-Lista团队比较了地中海饮食和低脂饮食对心血管疾病长期二级预防的效果。该项成果发表在2022年5月4日出版的《柳叶刀》上。

地中海饮食和低脂饮食对心血管疾病的一级预防有效。研究组进行了一项长期随机试验,来比较这两种饮食在心血管疾病二级预防中的效果。

研究组在西班牙雷纳索非亚大学医院进行了一项单中心随机临床试验。安达卢西亚公共卫生学院以1:1的比例随机分配患有冠心病的患者(年龄20-75岁)接受地中海饮食或低脂饮食干预,并随访7年。临床研究人员(医生、研究人员和临床终点委员会成员)被蒙蔽接受治疗任务。由一组营养师进行饮食干预。主要结局(通过治疗意向评估)是重大心血管事件的综合结果,包括心肌梗死、血运重建、缺血性中风、外周动脉疾病和心血管死亡。

2009年10月1日至2012年2月28日,研究组共招募了1002名患者,其中低脂饮食组500名(49.9%),地中海饮食组502名(50.1%)。1002例患者的平均年龄为59.5岁,其中827例(82.5%)为男性。共有198名参与者发生主要终点,其中地中海饮食组87人,粗发生率为每1000人-年28.1例;低脂饮食组111人,粗发生率为每1000人-年37.7例。

不同模型的多变量校正危险比(HRs)范围为0.719-0.753,有利于地中海饮食。这些影响在男性中更为明显,地中海饮食组414名男性中有67名(16.2%)出现主要终点,而低脂饮食组413名男性中有94名(22.8%),多重校正后的HR为0.669,而175名女性在各组之间没有显著差异。

研究结果表明,地中海饮食在二级预防重大心血管事件方面优于低脂饮食。该结果与临床实践相关,支持在二级预防中使用地中海饮食。

附:英文原文

Title: Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial

Author: Javier Delgado-Lista, Juan F Alcala-Diaz, Jose D Torres-Pea, Gracia M Quintana-Navarro, Francisco Fuentes, Antonio Garcia-Rios, Ana M Ortiz-Morales, Ana I Gonzalez-Requero, Ana I Perez-Caballero, Elena M Yubero-Serrano, Oriol A Rangel-Zuiga, Antonio Camargo, Fernando Rodriguez-Cantalejo, Fernando Lopez-Segura, Lina Badimon, Jose M Ordovas, Francisco Perez-Jimenez, Pablo Perez-Martinez, Jose Lopez-Miranda, Juan F Alcala-Diaz, Yolanda Almaden Pea, Enrique Aranda, Antonio P Arenas de Larriva, Lina Badimon, Juan J Badimon, Angeles Blanco-Molina, Ruth Blanco-Rojo, Julia Bolivar-Muoz, Javier Caballero-Villarraso, Antonio Camargo, Javier Chica, Andreea Corina, Juan Criado-Garcia, Cristina Cruz-Teno, Antonio Daponte-Codina, Eduardo de Teresa Galvan, Nieves Delgado-Casado, Javier Delgado-Lista, Ramon Estruch, Juan M Fernandez, Carolina Fernandez-Gandara, Francisco Fuentes-Jimenez, Sonia Garcia-Carpintero Fernandez-Pacheco, Antonio Garcia-Rios, Francisco Gomez-Delgado, Angela Gomez-Garduo, Purificacion Gomez-Luna, Maria J Gomez-Luna, Lorena Gonzalez-Guardia, Ana I. Gonzalez-Requero, Francisco M Gutierrez-Mariscal, Carmen M Haro-Mariscal, Rosa Jimenez-Lucena, Ana I. Jimenez-Morales, Ana Leon-Acua, Jose Lopez-Miranda, Fernando Lopez-Segura, Carmen Marin-Hinojosa, Maria E Meneses Alvarez, Dolores Mesa-Luna, Maria N Moya-Garrido, Ignacio Muoz-Carvajal, Vanessa Navarro-Martos, Juan J Ochoa, Jose M Ordovas, Juan A Ortiz-Minuesa, Ana M Ortiz-Morales, Manuel Pan, Patricia Pea-Orihuela, Ana I Perez-Caballero, Isabel Perez-Corral, Francisco Perez-Jimenez, Pablo Perez-Martinez, Francesc X Pi-Sunyer, Gracia M Quintana-Navarro, Irene Ramirez-Lara, Oriol A Rangel-Zuiga, Fernando Rodriguez-Artalejo, Fernando Rodriguez-Cantalejo, Miguel A Romero, Irene Roncero-Ramos, Juan A. Ruano-Ruiz, Joaquin Ruiz de Castroviejo, Pablo Sanchez-Villegas, Jose Suarez de Lezo, Javier Suarez de Lezo, Jose D Torres-Pea, Cristina Vals-Delgado, Roberto Valverde, Francisco Visioli, Elena M Yubero-Serrano

Issue&Volume: 2022-05-04

Abstract:

Background

Mediterranean and low-fat diets are effective in the primary prevention of cardiovascular disease. We did a long-term randomised trial to compare the effects of these two diets in secondary prevention of cardiovascular disease.

Methods

The CORDIOPREV study was a single-centre, randomised clinical trial done at the Reina Sofia University Hospital in Córdoba, Spain. Patients with established coronary heart disease (aged 20–75 years) were randomly assigned in a 1:1 ratio by the Andalusian School of Public Health to receive a Mediterranean diet or a low-fat diet intervention, with a follow-up of 7 years. Clinical investigators (physicians, investigators, and clinical endpoint committee members) were masked to treatment assignment; participants were not. A team of dietitians did the dietary interventions. The primary outcome (assessed by intention to treat) was a composite of major cardiovascular events, including myocardial infarction, revascularisation, ischaemic stroke, peripheral artery disease, and cardiovascular death. This study is registered with ClinicalTrials.gov, NCT00924937.

Findings

From Oct 1, 2009, to Feb 28, 2012, a total of 1002 patients were enrolled, 500 (49·9%) in the low-fat diet group and 502 (50·1%) in the Mediterranean diet group. The mean age was 59·5 years (SD 8·7) and 827 (82·5%) of 1002 patients were men. The primary endpoint occurred in 198 participants: 87 in the Mediterranean diet group and 111 in the low-fat group (crude rate per 1000 person-years: 28·1 [95% CI 27·9–28·3] in the Mediterranean diet group vs 37·7 [37·5–37·9] in the low-fat group, log-rank p=0·039). Multivariable-adjusted hazard ratios (HRs) of the different models ranged from 0·719 (95% CI 0·541–0·957) to 0·753 (0·568–0·998) in favour of the Mediterranean diet. These effects were more evident in men, with primary endpoints occurring in 67 (16·2%) of 414 men in the Mediterranean diet group versus 94 (22·8%) of 413 men in the low-fat diet group (multiadjusted HR 0·669 [95% CI 0·489–0·915], log-rank p=0·013), than in 175 women for whom no difference was found between groups.

Interpretation

In secondary prevention, the Mediterranean diet was superior to the low-fat diet in preventing major cardiovascular events. Our results are relevant to clinical practice, supporting the use of the Mediterranean diet in secondary prevention.

DOI: 10.1016/S0140-6736(22)00122-2

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00122-2/fulltext

期刊信息

LANCET:《柳叶刀》,创刊于1823年。隶属于爱思唯尔出版社,最新IF:59.102
官方网址:http://www.thelancet.com/
投稿链接:http://ees.elsevier.com/thelancet