素食饮食模式与心血管风险因素和疾病预防：系统综述

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS American journal of preventive cardiology Pub Date : 2024-09-28 DOI:10.1016/j.ajpc.2024.100868

Matthew J. Landry , Katelyn E. Senkus , A Reed Mangels , Nanci S. Guest , Roman Pawlak , Sudha Raj , Deepa Handu , Mary Rozga

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引用次数: 0

摘要

背景饮食对心血管疾病（CVD）的发病风险有重大影响，而心血管疾病是美国人的主要死因。随着素食饮食模式越来越多地被纳入临床实践指南，有必要回顾有关这些饮食模式是否以及如何降低心血管疾病风险的最新证据。目标本系统综述比较了普通人群中假定健康成年人（≥18 岁）的素食、纯素和非素食饮食模式与心血管疾病健康结果和风险因素之间的关系。方法检索了 2018 年至 2024 年 3 月期间发表的系统综述 (SR)，包括 MEDLINE、CINAHL、Cochrane Databases of Systematic Reviews、Food Science Source 和 SportsDiscus 数据库。符合条件的 SR 和荟萃分析研究了与荤食相比，素食或纯素饮食与心血管疾病危险因素和疾病结局之间的关系。对SR进行一式两份筛选，并使用AMSTAR2对SR质量进行评估。采用推荐、评估、发展和评价分级（GRADE）方法对证据的总体确定性（COE）进行了评估。结果在数据库检索中确定了 758 篇文章，21 篇 SR 符合纳入标准。以普通人群为对象的 SR 主要是观察性证据。与荤食相比，素食（包括纯素）膳食模式与心血管疾病发病风险降低[相对风险：0.85 (0.79, 0.92)]和心血管疾病死亡率降低[危险比：0.92 (0.85, 0.99)]相关。素食饮食模式与心血管疾病风险因素相关，包括血压[收缩压平均差（95 % CI）：-2.56 mmHg (-4.66, -0.445)]、低密度脂蛋白胆固醇[-0.49 mmol/l (-0.62, -0.36)]和体重指数[-1.72 kg/m2 (-2.30, -1. 16)]。结论从业人员可以考虑推荐素食饮食模式，以降低心脏代谢风险因素以及心血管疾病发病率和死亡率风险。

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Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews

Background

Diet significantly influences the risk of developing cardiovascular disease (CVD), the leading cause of death in the United States. As vegetarian dietary patterns are increasingly being included within clinical practice guidelines, there is a need to review the most recent evidence regarding if and how these dietary patterns mitigate CVD risk.

Objective

This umbrella review of systematic reviews compared the relationships between vegetarian, vegan and non-vegetarian dietary patterns and CVD health outcomes and risk factors among presumably healthy adults (≥18 years) in the general population.

Methods

MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, Food Science Source and SportsDiscus databases were searched for systematic reviews (SRs) published from 2018 until March 2024. Eligible SRs and meta-analyses examined relationships between vegetarian or vegan diets and CVD risk factors and disease outcomes compared to non-vegetarian diets. SRs were screened in duplicate, and SR quality was assessed with AMSTAR2. The overall certainty of evidence (COE) was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) method.

Results

There were 758 articles identified in the databases’ search and 21 SRs met inclusion criteria. SRs targeting the general population had primarily observational evidence. Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD incidence [Relative Risk: 0.85 (0.79, 0.92)] and CVD mortality [Hazard Ratio: 0.92 (0.85, 0.99)] compared to non-vegetarian diets. Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure [systolic mean difference (95 % CI): -2.56 mmHg (-4.66, -0.445)], low-density lipoprotein cholesterol [-0.49 mmol/l (-0.62, -0.36)], and body mass index [-1.72 kg/m² (-2.30, -1.16)] compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations in a novel meta-analysis [-0.55 mg/l (-1.07, -0.03)].