血脂偏高学龄儿童膳食干预效果分析

目的　评价血脂偏高学龄儿童的膳食干预效果。方法　对 316名 7～ 11岁在校儿童进行血脂谱水平测定 ,以总胆固醇 (TC)≥ 4 .2 6mmol/L或低密度脂蛋白胆固醇 (LDL C)≥ 2 .2 3mmol/L确定膳食干预对象 ,随机分为干预组 (12 0人 )和对照组 (40人 ) ;干预组遵循低胆固醇、低饱和脂肪酸食谱方案 ,干预期 3个月 ;干预前后对两组人群进行膳食调查、问卷调查及体格检查 (身高、体重、皮褶厚度等 )。结果　膳食干预后干预组儿童TC、LDL C水平与对照组相比无明显改变 (干预前分别为4 .6 4mmol/L和 2 .6 6mmol/L ,干预后分别为 4 .6 8mmol/L和 2 .6 2mmol/L ,P >0 .0 5 ) ,载脂蛋白A1(apoA1)水平由干预前 1378.4mg/L升高为 14 4 1.3mg/L(P <0 .0 5 ) ;膳食总能量、胆固醇、饱和脂肪酸 (SFA)摄入明显减少 ,其中脂肪供能比由干预前的 4 0 .7%下降到 31.2 % ,SFA供能比已达到“膳食控制一级方案”要求 (7.7% <10 % )。此外干预组儿童健康知识水平提高 ,不良生活、饮食习惯改善 (总分由干预前 2 4 .6上升为 2 7.4 ) ;身高增长与对照组一致。结论　对血脂偏高儿童进行以家庭为基础、以膳食调整为主的高危干预策略可有效提高血脂偏高儿童的健康知识水平 ,改善其不良生活及饮食习惯 ,同时不影响儿童的正常生长发育。     

食品级藏灵菇培养液对高脂血症患者血脂血压的影响

目的观察食品级藏灵菇培养液对高脂血症患者血脂、血压的调节效果.方法选择高脂血症患者90例,随机分为对照组、牛奶组和试验组,每组30例,试验组每日睡前摄入藏灵菇培养液4 ml/kg体重,牛奶组喝等剂量牛奶,连续服用20天;对照组除不饮用藏灵菇培养液和牛奶外其他试验条件与试验组和牛奶组保持一致.3组试验前后分别测定血脂(总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、血压.结果服用藏灵菇培养液的高脂血症患者试验前后血清总胆固醇的降低幅度大于牛奶组和对照组(P＜0.05),牛奶组与对照组之间差异无显著性(P＞0.05).甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血压试验前后的改变3组间差异均无显著性(P＞0.05).结论服用藏灵菇培养液对高脂血症患者血脂中的胆固醇有一定的降低作用.     

孕妇血脂与新生儿体重的关系

【目的】　探讨孕妇血脂变化与新生儿体重的关系。　【方法】　用日立 7170A全自动生化分析仪对 10 0例妊娠期妇女血清胆固醇 (CHO)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL C)、低密度脂蛋白胆固醇 (LDL C)、载脂蛋白A1(ApoA1)及载脂蛋白B10 0 (ApoB10 0 )进行分析 ,并跟踪观察其所生新生儿的体重。　【结果】　妊娠期妇女 63 %表现为高脂血症 (CHO >6.47mmol/L、TG >2 .3 0mmol/L)。妊娠早期 (17周以前 )血脂各项参数与对照组相比差异无显著性(P >0 .0 5 ) ;妊娠中期 (17～ 3 2周 )血脂各项参数均升高 ,与对照组相比差异有极显著性 (P <0 .0 1) ;妊娠晚期 (3 3周以后 )血脂升高更明显 ,与妊娠中期相比差异有显著性 (P <0 .0 5或P <0 .0 1)。高血脂孕妇所生超体重儿 (体重 >40 0 0 g)的比率 (2 3 .8% )明显高于血脂正常孕妇 (5 .4% ) ,经 χ2 检验 ,P <0 .0 5。孕妇血脂 (CHO)含量与新生儿体重呈正相关 (r=0 .5 72 8,P <0 .0 1)。　【结论】　高血脂孕妇所生超体重儿的比率增大 ,超体重儿可能是导致儿童肥胖症的一个原因。     

膳食脂肪对高血压人群血脂水平的影响

目的 探讨改善膳食脂肪摄入情况对血脂的影响。方法 对营养健康教育前后高血压患者的膳食脂肪摄入情况及血脂水平进行测定分析。结果 基线调查表明人群膳食脂肪及胆固醇摄入量过高,脂肪供能比占总热能的30％以上;血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL－L）水平偏高。相关分析表明,体质指数（BMI）和饱和脂肪酸（SFA）与血清TC、TG、LDL－C呈正相关;高密度脂蛋白（HDL－C）／TC与BMI、SFA呈负相关,而与单不饱和脂肪酸（MUFA）呈正相关。进行社区营养干预后,干预组脂肪供能比小于总热能的30％,与对照组相比及自身干预前后比较差异均有显著性,胆固醇摄入量有下降趋势;干预组人群血脂TC、LDL－C水平显著降低。结论 研究结果提示减少膳食脂肪和胆固醇摄入量,适当增加单不饱和脂肪酸摄入对高血压人群降低血脂水平,控制血压是有效的。     

两个社区肥胖成人干预措施研究

[目的 ]　研究成人肥胖特点 ,探索有效干预措施。　 [方法 ]　对上海市卢湾区 2个社区体重指数 (BMI)≥ 2 5的肥胖成人采取整群抽样法、询问法和问卷式调查 ,并随机抽取其中 3 0 %的肥胖者进行干预前后的对比分析。　 [结果 ]　干预后干预组的健康认知程度提高 ,同时有行为发生改变的趋势。表现在对肥胖危害认识和中国居民膳食指南的知晓率明显提高 (P <0 .0 1) ,脂肪摄入量明显下降 ,且摄入总量低于对照组 (P <0 .0 5 ) ;运动频率明显提高 ,完全不运动者由干预前的 5 2 .3 8%下降至干预后的 19.0 5 % (P <0 .0 5 ) ;血清生化方面 ,高密度脂蛋白 -C(HDL -C)有显著上升且明显高于对照组 (P <0 .0 0 5 ) ,而低密度脂蛋白 -C(LDL -C)明显的下降 (P <0 .0 0 1)。　 [结论 ]　脂肪摄入过量、运动频率过低、对肥胖控制和预防相关知识的缺乏是当前成人肥胖特点也是控制的关键点。提示在社区进行肥胖干预是可行有效的     

脂蛋白脂酶基因PvuⅡ位点多态性与高脂血症人群膳食干预易感性的关系

为了解脂蛋白脂酶 (LPL)基因PvuⅡ位点多态性与高脂血症人群膳食干预效果的关系 ,从北京市西城区 8个社区居民中筛出 43 6名高脂血症患者 ,分为干预组 (2 48人 )和对照组 (188人 ) ;对两组人群进行血脂谱水平检测、膳食调查、体格检查及LPL基因PvuⅡ位点多态性检测 (PCR RFLP方法 ) ,并对干预组进行为期 6个月的膳食干预。结果表明与对照组相比 ,干预组膳食总能量、脂肪供能比及胆固醇摄入量明显降低 ,血清TC、LDL C和HDL C水平明显下降 (P <0 0 5 ) ,且LPL PvuⅡ位点 (+ +)基因型携带者TC和LDL C水平降低幅度大于 (+ - )及 (- - )基因型 ;多元线性回归分析显示膳食干预易感的因素包括LPL(+)等位基因、基限TC、LDL C水平较高以及超重等。本研究可初步得出LPL基因PvuⅡ位点 (+)等位基因与高脂血症人群膳食干预易感性密切相关 ,但限于研究对象的代表性该结论还需要进一步研究支持     

持续性护理在高脂血症患者护理中的应用评价

目的:分析评价持续性护理对高脂血症患者的临床效果。方法:选取2014年11月~2015年11月在我院治疗高脂血症的患者96例,按不同的护理方式分为试验组和对照组2组,各48例,对照组仅进行常规护理,试验组则在上述护理基础上实行全面综合护理干预,分析比较2组患者的血脂水平[包括血清总胆固醇(TG)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDL—C)和低密度脂蛋白胆固醇(HDL—C)]变化情况及患者的满意度。结果:2组经护理后,试验组的血脂水平较对照组降低显著,差异具有统计学意义(P0.05),且其满意度(92.68%)较对照组(67.34%)高,差异具有统计学意义(P0.05)。结论:对于高脂血症患者,采用持续性护理的手段可明显降低其血脂水平,临床效果显著,患者较为满意,值得临床推广。     

江苏省常熟市农村居民血脂水平调查

目的　了解我市农村社区居民血脂水平及影响因素。方法　采用分层整群抽样的方法 ,随机抽取我市农村 5个村 ,所有 35岁以上的常住居民计 30 6 1人 ,测量身高、体重、血压 ,检测血脂、血糖并收集其他相关资料。结果　我市农村社区 35岁以上居民的血脂水平 :总胆固醇 (TC)为 (4 4 0± 0 83)mmol/L ;甘油三酯 (TG)为 (1 5 3± 0 88)mmol/L ;高密度脂蛋白 (HDL -C)为 (1 2 7± 0 31)mmol/L ;低密度脂蛋白 (LDL -C)为 (2 4 3± 0 71)mmol/L。经分析发现年龄、性别、饮酒、血压、空腹血糖、体质指数、腰臀比可影响血脂水平。结论　应大力开展健康教育及定期的血脂普查工作 ,以降低我市居民心血管疾病的发病率。     

大豆活性肽对大鼠体内高胆固醇代谢的影响

目的　探讨膳食大豆活性肽对高胆固醇模型大鼠血浆胆固醇及其有关血脂指标的影响 ,研究其可能的作用机制。方法　 4周龄断乳雄性Wistar大鼠 ,经 2 8d诱发高血胆固醇以后 ,按体重和血浆总胆固醇浓度将动物均衡分为 2组 ,分别喂饲含大豆活性肽和酪蛋白的纯合成高脂饲料 5 6d ,断头处死动物。实验结果用SPSS统计软件进行统计分析 (单因素F检验 )。结果　经 2 8d诱导高脂模型后 ,实验模型大鼠的TC水平为 ( 2 0 2± 0 2 7)mmol/L (n =2 1) ,而喂饲基础饲料的阴性对照组大鼠分别为 ( 1 33± 0 2 0 )mmol/L (n =9)。高血胆固醇模型大鼠的血浆总胆固醇(TC)浓度分别是阴性对照组的 1 5 1倍。又经 5 6d喂饲含有处理因素的饲料后 ,酪蛋白组和大豆活性肽组实验动物体重分别增加了 ( 198 5和 119 3) g ;TC水平分别为 ( 6 4 1± 0 5 7)和 ( 3 0 1± 0 37)mmol/L ;TG水平分别为 ( 3 73±0 70 )和 ( 1 0 9± 0 34)mmol/L ;apoB分别为 ( 0 6 2± 0 11)和 ( 0 31± 0 0 7) g/L ;FT4分别为 ( 1 0 3± 0 2 2 )和 ( 1 76±0 30 ) pmol/L ;同酪蛋白组相比 ,大豆活性肽组动物体重及TC ,TG ,apoB含量显著降低 ,而FT4水平显著高于酪蛋白组 (P <0 0 5 )。结论　膳食中大豆活性肽的摄入可降低高血胆固醇模型大鼠TC、     

社区综合干预对代谢综合征高危人群心血管病危险因素的控制作用

目的 观察社区综合干预对代谢综合征高危人群心血管病危险因素的影响.方法 选取代谢综合征高危人群100例,按随机数字表法分为社区综合干预组(50例)与对照组(50例).社区综合干预组予以健康教育干预、健康生活习性干预、健康行为干预、药物干预等措施;对照组接受社会自然干预.两组均随访1年.评估两组人群干预前后的体质指数、腰围、血压、空腹血糖、血脂、血尿酸的变化.结果 社区综合干预组干预后进行体育锻炼、饮食控制、依从服药人数分别增加12％、16％、18％,吸烟、饮酒人数分别减少8％、6％;对照组进行体育锻炼、饮食控制、依从服药人数分别增加2％、0、4％,吸烟、饮酒人数分别减少4％、2％;社区综合干预组依从性明显高于对照组(P＜0.05).两组干预前腰围、体质指数、收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸水平比较差异无统计学意义(P＞0.05).干预后两组除高密度脂蛋白胆固醇指标外,其他各指标比较差异均有统计学意义(P＜ 0.05或＜0.01).结论 社区综合干预可改善代谢综合征高危人群的肥胖、血脂紊乱,降低血压、血糖、血尿酸水平.     

The substitution of sucrose polyester for dietary fat in obese, hypercholesterolemic outpatients

Our aim was to determine the effects of the substitution of sucrose polyester (SPE) for dietary fat in a 16-week outpatient study in 36 obese subjects with primary hypercholesterolemia. The subjects were randomized into three groups who followed a 16-week treatment period where all subjects received hypocaloric diets which provided approximately 7 kcal/lb body weight, a polyunsaturated/saturated (P/S) fat ratio of 0.9, and 180 mg cholesterol/day. The percentages of calories as fat in the 3 groups were as follows: a low fat diet group (n = 12) received 27% of dietary calories as fat, a low fat plus SPE group (n = 13) received 25% of calories as fat plus 27 g SPE/day as a bread spread and salad dressing, and a third group (placebo, n = 11) received 37% of calories as fat with a 27 g/day conventional fat placebo (bread spread and salad dressing). Mean weight loss from baseline in the 16 week treatment period was 2.6, 3.9, and 3.4% respectively in the placebo, diet, and SPE groups, p less than .05 for each group, without significant differences between the groups. There was a mean reduction of low density lipoprotein cholesterol (LDL-C) of 16% in the SPE group (p less than .05), more than twice the reductions in the placebo and diet groups, 5% and 6%, respectively. There was a mean 20% reduction in the SPE group in triglyceride and very low density lipoprotein cholesterol (p less than .05), compared to 7 and 10% reductions in the placebo and diet groups respectively. The degree of weight loss was correlated with the degree of reduction in LDL-C in the low fat diet group, and in the low fat diet group plus SPE (r = 0.59 for both groups). Without confounding by different levels of dietary cholesterol or P/S, SPE induced significant reductions in LDL-C in hypercholesterolemic obese subjects beyond the effects of weight loss alone. The effects of SPE were significantly greater than those achieved by the use of a diet which severely limited conventional dietary fat intake (to 40 g/day). SPE in the form of a bread spread and a salad dressing is a practical formulation for outpatient hypocholesterolemic low fat diets and provides the lubricity and organoleptic benefits of authentic foods without the dense caloric content of digestible fats.     

Effects on serum lipids of adding instant oats to usual American diets.

This study was designed as a test of the serum lipid response and dietary adaptation to recommended daily inclusion of instant oats in an otherwise regular diet. Hypercholesterolemic adults were randomly assigned to a control or intervention group. Participants in the intervention group were given packages of instant oats and requested to eat two servings per day (approximately two ounces dry weight), substituting the oats for other carbohydrate foods in order to maintain baseline calorie intake and keep weight stable. Serum lipids were measured in blood collected by venipuncture at baseline, four weeks, and eight weeks. Baseline mean total cholesterol (TC) levels were 6.56 mmol/L and 6.39 mmol/L for intervention and control groups, respectively. After eight weeks, mean serum total cholesterol of the intervention group was lower by -0.40 mmol/L, and mean net difference in TC between the two groups was 0.32 mmol/L (95% CI: 0.09, 0.54). Low-density lipoprotein-cholesterol was similarly reduced with mean net difference of 0.25 mmol/L (95% CI: 0.02, 0.48) between the two groups. Mean soluble fiber intake increased along with slight self-imposed reductions in mean total fat, saturated fat, and dietary cholesterol intake in the intervention group. Neither group changed mean body weight. Daily inclusion of two ounces of oats appeared to facilitate reduction of serum total cholesterol and LDL-C in these hyperlipidemic individuals.     

Dietary modulators of lipid metabolism in the Indian diet-heart study (I.D.H.S.).

Of the 621 adults (25 to 65 years of age, 531 males) with either risk factors or with coronary heart disease (CHD) 310 subjects were given a cardiovasoprotective (CVP) diet (group A) and 311 subjects a normal diet (group B) in a randomized, single blind and controlled fashion. Risk factors and incidence of CHD were comparable between the two groups. The intervention group received a significantly higher percentage of calories in relation to complex carbohydrates, vegetable proteins, polyunsaturated fatty acids and high P:S ratio diet as compared to the control group. The control group received higher saturated fat and cholesterol. Compliance was assessed by dietary questionnaire during the follow-up. After 8 weeks of dietary trial, there was a significant decrease in mean serum total cholesterol (8.2 vs 2.1%), low density lipoprotein (LDL) cholesterol (9.8 vs. 2.7%) and triglyceride (11.2 vs 5.8%) in the intervention group compared to baseline levels and changes in control subjects. Body weight and physical activity at the entry to study and during the trial were similar in both groups. The decrease in mean HDL cholesterol were insignificant both in the intervention (4.3%) and control group (5.0%). There were no adverse effects of diet during the 8 weeks of trial. It is possible that a diet with 27.5% energy from total fat including 10.1% energy from monounsaturated fatty acids, P:S ratio 1.38, 120 mg dietary cholesterol, 26.0 g dietary fibre per 1000 kcal would modulate the lipid metabolism resulting in a significant reduction in serum total cholesterol, LDL cholesterol and triglyceride with no reduction in HDL cholesterol. This diet may be capable of reducing CHD incidence and mortality in the long term Indian diet-heart study (IDHS).     

Variations in body composition and plasma lipids in response to a high-carbohydrate diet

OBJECTIVE: To examine the extent to which variations in body composition modulate changes in the lipid profile in response to the ad libitum consumption of a diet rich in carbohydrates (CHOs) (high-CHO diet: 58% of energy as CHOs) or high in fat and in monounsaturated fatty acids (MUFAs) (high-MUFA diet: 40% of energy as fat, 23% as MUFAs). RESEARCH METHODS AND PROCEDURES: Sixty-three men were randomly assigned to one of the two diets that they consumed for 6 to 7 weeks. Body composition and fasting plasma lipid levels were measured at the beginning and the end of the dietary intervention. RESULTS: The high-CHO and high-MUFA diets induced significant and comparable reductions in body weight and waist circumference. These changes were accompanied by significant and comparable (p < 0.01) reductions in total plasma cholesterol and low-density lipoprotein cholesterol levels. However, the high-MUFA diet had more beneficial effects on plasma triglyceride concentrations (p < 0.01) and on plasma high-density lipoprotein cholesterol levels (p = 0.02) compared with the high-CHO diet. Diet-induced changes in waist circumference were significantly associated with changes in low-density lipoprotein cholesterol levels in the high-CHO group (r = 0.39, p = 0.03) but not in the high-MUFA group (r = 0.16, p = 0.38). DISCUSSION: Improvements in plasma lipids induced by the ad libitum consumption of a high-CHO diet seem to be partly mediated by changes in body weight, whereas lipid changes induced by the high-MUFA diet seem to be independent of changes in body weight.     

Effect of dietary control and exercise training on daily food intake and serum lipids in postmyocardial infarction patients.

The effects of 12 weeks of exercise training without dietary control (n = 30) and exercise training with dietary control by dietition counseling (n = 30) and exercise training with dietary control by dietition counseling (n = 30) on serum cholesterol, serum triglycerides, and total substrate contents were studied in 60 postmyocardial infarction patients. Both groups showed reductions (P less than 0.01) in mean total daily kilocalories consumed (2867 +/- 82 versus 2088 +/- 77 and 2848 +/- 15 versus 1285 +/- 68, respectively); however, no significant change occurred in total body weight. The dietary control group consumed relatively more kilocalories as protein than the group without dietary control (285 of 1,285 versus 389 of 2,088, respectively) and less (P less than 0.05) as fat (443 of 1285 versus 804 of 2,089, respectively). Both groups had lower (P less than 0.01) mean daily dietary cholesterol after 12 weeks (811 +/- 44 versus 232 +/- 17 mg) versus (325 +/- 18 versus 309 +/- 23 mg, respectively). A reduction in serum cholesterol (P less than 0.05) was seen in the dietary control group (270 +/- 8 versus 243 +/- 7 mg/dl) but not in the group without dietary control (260 +/- 6 versus 261 +/- 7 mg/dl). The dietary control group had a lower mean triglyceride level (P less than 0.05) (229 +/- 24 versus 155 +/- 18 mg/dl)) but no differences were seen in the group without dietary control (189 +/- 15 versus 180 +/- 13 mg/dl). It is concluded that significant reductions in caloric intake and daily cholesterol compliment the effects of exercise training in postmyocardial infarction patients by increasing substrate protein:fat consumption ratio and by reducing serum cholesterol and triglycerides. These effects are not seen with exercise training alone.     

大豆异黄酮对大鼠脂质的影响及减肥作用研究

目的建立大鼠肥胖和高脂模型，观察大豆异黄酮对肥胖、高血脂大鼠的减肥降脂作用，并研究其作用机理。方法选用SD雄性大鼠、喂饲高脂饲料，建立肥胖和高血脂模型，对大豆异黄酮进行减肥降脂试验。结果大豆异黄酮中、高剂量组均能明显降低高血脂大鼠血清胆固醇（TC）、甘油三脂（TG）和低密度脂蛋白（LDL-C）含量；高剂量组能明显提高大鼠血清高密度脂蛋白（HDL-C）含量，同时也明显降低肥胖大鼠的体重和体内脂肪重。结论大豆异黄酮具有减肥降脂作用，其机理可能与调节机体脂质代谢有关。     

Relationships of dietary fat consumption to serum total and low-density lipoprotein cholesterol in hispanic preschool children

BACKGROUND. Studies of the relationship between dietary fat intake and serum lipids in young children have yielded inconclusive results. We studied this relationship in 108 Hispanic children ages 4-5 years. METHODS. Four 24-hr recalls approximately 3 months apart and two Willett semiquantitative food frequency questionnaires approximately 6 months apart were obtained by interviewing the children's mothers. Diet measures were averaged for the multiple administrations of each of these instruments. RESULTS. Based on the 24-hr recalls, children in the highest tertile of total fat consumption (36.2% of total calories) compared with the lowest tertile (30.2% of total calories) had mean total serum cholesterol of 4.32 mmol/liter (167 mg/dl) vs 3.91 mmol/liter (151 mg/d) (test for linear trend across tertiles, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.74 mmol/liter (106 mg/dl) vs 2.29 mmol/liter (89 mg/dl) (test for linear trend, P less than 0.01). Children in the highest tertile of saturated fat consumption (14.6% of total calories) compared with the lowest tertile (11.2% of total calories) had mean total serum cholesterol of 4.39 mmol/liter (170 mg/dl) vs 3.97 mmol/liter (154 mg/dl) (test for linear trend, P less than 0.05) and mean low-density lipoprotein cholesterol of 2.80 mmol/liter (108 mg/dl) vs 2.35 mmol/liter (91 mg/dl) (test for linear trend, P less than 0.01). These relationships remained significant when calorie-adjusted nutrient intakes were examined and after adjustment in multiple linear regression models for age, sex, and body mass index, with the exception of the association of calorie-adjusted total fat with total serum cholesterol level (P = 0.07). Similar results were obtained using the Willett questionnaires. CONCLUSIONS. These findings indicate that dietary fat, particularly saturated fat consumption, is an important correlate of blood lipid levels in preschool children. These are also the first reported data indicating that the Willett questionnaire, as a method for measuring the atherogenic components of diet, has criterion-related validity in young children.     

岳阳楼社区糖尿病高危人群非药物干预效果

目的探讨2型糖尿病高危个体非药物干预的效果.方法:运用知己能量监测仪和知己健康管理软件对岳阳楼区三个社区筛查人群中的2型糖尿病高危个体71例进行运动和饮食管理指导,进行3个月的强化期管理和9个月的随访,建立Epidata数据库,用SPSS13.0软件包对数据进行统计学分析. 结果经对高危个体12个月的生活方式干预,体重,腰围,体脂率,收缩压,舒张压,血糖,总胆固醇,甘油三酯的变化差异有统计学意义(t=11.70,9.86,9.52,9.45,7.89,4.87,2.43,3.86,P <0.05.),但高密度脂蛋白和低密度脂蛋白变化没有统计学意义,日平均总运动量,有效运动量,有效运动时间,日平均膳食摄入能量均比一年前有显著改善,差异有统计学意义(p<0.01).干预组的腰围,血压,空腹血糖,总胆固醇,甘油三脂与对照组一年后的差异亦有统计学意义(p<0.01). 结论对依从性好的2型糖尿病高危个体进行生活方式干预可以产生显著效果,值得宣传和推广.     

Effects of saturated, monounsaturated, and omega-6 polyunsaturated fatty acids on plasma lipids, lipoproteins, and apoproteins in humans

The effects of dietary fats on plasma cholesterol, serum lipoproteins, and apoproteins (Apo), A-1, B, and CIII were studied. Twelve men consumed three different cholesterol-free formula diets in which polyunsaturated and saturated fats were partially substituted (20% of calories) for monoenoic fats with a constant of 40% of calories from fat. Total cholesterol and low-density lipoprotein cholesterol dropped from base-line values of 166 and 103 to 133 and 81 mg/dl (sat), 127 and 71 mg/dl (mono), and 123 and 65 mg/dl (poly), respectively. High-density lipoprotein cholesterol changed very little from base-line values of 46 to 40 mg/dl (sat), 45 mg/dl (poly), and 43 mg/dl (mono). The plasma concentrations of ApoB declined from base-line values of 80.3 mg/dl to 54.6 mg (mono), 51.8 mg (poly), and 59.6 mg (sat) while Apo CIII and Apo AI did not show any changes. This study demonstrates that: 1) changes in dietary fat affect serum lipids, lipoproteins, and apoproteins even when consumed on a cholesterol-free diet, and 2) omega-6 polyunsaturated fat lowers low-density lipoprotein cholesterol, total cholesterol, and ApoB to a greater extent than monounsaturated or saturated fat, 3) consumption of a cholesterol-free formula diet results in significant decreases in the concentrations of total and low-density lipoprotein cholesterol in plasma when compared to values obtained on a mixed food home diet containing approximately 300 mg cholesterol/day.     

Dietary intake and changes in lipoprotein lipids in obese, postmenopausal women placed on an American Heart Association Step 1 diet

BACKGROUND: Dietary intake and changes in lipoprotein lipids in obese, postmenopausal women placed on an American Heart Association Step 1 diet. OBJECTIVE: The purpose of this study was to determine the specific dietary factors associated with the commonly observed decrease in HDL-C concentration in obese, postmenopausal women placed on a low-fat diet. DESIGN/SUBJECTS/INTERVENTION: Dietary intake, lipoprotein lipid concentrations, and body weight were measured before and after 10 weeks of instruction in the principles of the American Heart Association (AHA) Step 1 diet in 55 overweight and obese (body mass index=33+/-4 kg/m2), sedentary, postmenopausal women (mean age 59+/-5 years). RESULTS: The percent of energy obtained from total fat, monounsaturated, polyunsaturated, saturated fat, and dietary cholesterol decreased significantly after dietary intervention, while the polyunsaturated:saturated ratio and the percent of energy obtained from total carbohydrate, complex carbohydrate, and simple carbohydrate increased. On average, the women lost a small, but significant, amount of body weight (2%+/-3%, P<.0001). Adherence to the AHA diet reduced total cholesterol (-8%+/-8%), LDL-C (-6%+/-11%), and HDL-C (-16%+/-10%). The only dietary change that predicted decreases in HDL-C concentrations was the increase in the percent of energy from simple sugar (r=-0.32, P<.05). There were no relationships between changes in HDL-C and changes in percent of energy from fat (r=0.16), saturated fat (r=0.07), polyunsaturated fat (r=0.04), or monounsaturated fat (r=0.09). APPLICATIONS/CONCLUSIONS: In postmenopausal women, a dietary reduction in total fat, saturated fat, and cholesterol reduces body weight, total cholesterol, and LDL-C, but substitution of simple sugar for dietary fat may lead to a reduction in HDL-C. Further research is needed to determine which specific simple sugars are contributing to diet-induced reductions in HDL-C in older women placed on a low-fat diet.