“大数据”证实:多吃坚果降低心血管疾病风险
2017/11/17
近日,发表在Journal of the American College of Cardiology杂志上的一项研究称,与从不或几乎不吃坚果的人相比,经常吃坚果(包括花生、核桃和树坚果)的人患心血管疾病或冠心病的风险更低。这是迄今为止“调查吃坚果频率与心血管疾病关联”最大的一项研究。


图片来源:网络

与先前将各种坚果的消耗(nut consumption)作为一个整体来调查的研究不同,在该研究中,科学家们调查了特定类型的坚果与主要心血管事件之间的关联。


图片来源:JACC

21万人、长达32年的研究

具体来说,研究调查了超过21万人,包括来自Nurses' Health Study和Nurses' Health Study II项目的女性,以及来自Health Professionals Follow-up Study项目的男性,随访时间长达32年。研究人员每两年通过问卷调查的形式收集参与者的病史、生活方式、健康状况等信息。

最终统计显示,研究人员共记录了14,136例心血管疾病病例,包括 8,390 例冠心病病例和5,910例中风病例。

坚果摄入与心血管疾病负相关


图片来源:JACC

研究结果发现,总坚果摄入与总心血管疾病和冠心病之间存在一致的负相关。在分开调查个别坚果的消耗后发现,每周吃一次或更多次(one or more times per week)核桃与“患心血管疾病的风险降低19%,以及患冠心病的风险降低21%”有关。此外,与从不吃坚果的人相比,每周吃两次或更多次( two or more times per week)花生或树坚果(tree nuts)的参与者患心血管疾病的风险分别降低13%和15%,患冠心病的风险分别降低了15%和23%。

另一方面,与从不或几乎不吃坚果的人相比,每周吃5份或更多份坚果(five or more servings of nuts;1份为28 g)的参与者,患心血管疾病的风险降低14%,患冠心病的风险降低20%。当单独考虑树坚果、花生和核桃的消耗时,结果是相似的。

此外,没有证据表明,总的坚果消耗与中风风险之间存在关联,但吃花生和核桃与中风的风险成负相关,而吃树坚果与中风的风险无关。

支持健康饮食要增加各种坚果的摄入量


图片来源:哈佛陈曾熙公共卫生学院

领导该研究的哈佛陈曾熙公共卫生学院的Marta Guasch-Ferre博士说:“我们的发现支持增加各种坚果的摄入量,作为健康饮食模式的一部分,以降低普通人群患慢性疾病的风险。”

尽管这一研究中涉及的样本具有一定的局限性,但科学家们认为,这些结果可以推广到不同种族的男性和女性身上,因为没有理由期望潜在的机制是不同的。

西班牙Hospital Clínic的Emilio Ros博士在一篇社论中表示,这些发现强烈证明了坚果消耗与心脏疾病保护之间的联系,但是还要更多的研究要做。他说:“理想情况下,进一步的研究应该调查‘长期消耗补充到平常饮食中的坚果’对心血管代谢事件的影响。”

备注:之所以把花生算在内,是因为,尽管它们实质上是一种豆科植物,但它们与其他坚果具有相似的脂肪酸和营养成分。

参考资料:

Eating regular variety of nuts associated with lower risk of heart disease

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  • Nut Consumption and Risk of Cardiovascular Disease

    Abstract Background The associations between specific types of nuts, specifically peanuts and walnuts, and cardiovascular disease remain unclear. Objectives The authors sought to analyze the associations between the intake of total and specific types of nuts and cardiovascular disease, coronary heart disease, and stroke risk. Methods The authors included 76,364 women from the Nurses’ Health Study (1980 to 2012), 92,946 women from the Nurses’ Health Study II (1991 to 2013), and 41,526 men from the Health Professionals Follow-Up Study (1986 to 2012) who were free of cancer, heart disease, and stroke at baseline. Nut consumption was assessed using food frequency questionnaires at baseline and was updated every 4 years. Results During 5,063,439 person-years of follow-up, the authors documented 14,136 incident cardiovascular disease cases, including 8,390 coronary heart disease cases and 5,910 stroke cases. Total nut consumption was inversely associated with total cardiovascular disease and coronary heart disease after adjustment for cardiovascular risk factors. The pooled multivariable hazard ratios for cardiovascular disease and coronary heart disease among participants who consumed 1 serving of nuts (28 g) 5 or more times per week, compared with the reference category (never or almost never), were 0.86 (95% confidence interval: 0.79 to 0.93; p for trend = 0.0002) and 0.80 (95% confidence interval: 0.72 to 0.89; p for trend <0.001), respectively. Consumption of peanuts and tree nuts (2 or more times/week) and walnuts (1 or more times/week) was associated with a 13% to 19% lower risk of total cardiovascular disease and 15% to 23% lower risk of coronary heart disease. Conclusions In 3 large prospective cohort studies, higher consumption of total and specific types of nuts was inversely associated with total cardiovascular disease and coronary heart disease.

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