飲食型態與心血管疾病危險因子：人體與動物研究

Dietary patterns and cardiovascular disease risk factors: human and animal studies

米莉安(Miriam Adoyo Muga)

指導教授 ： 趙振瑞

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/博士(2016年)

摘要

n/a

關鍵字

飲食型 ； 心血管疾病危險因子

並列摘要

Background and Aim: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. CVD is often caused by sedentary lifestyles and Western dietary habits which are positively associated with elevated plasma lipid levels and a state of sub-acute chronic inflammation. An effective way to diminish the risk of CVD is to reduce causative risk factors such as lifestyle and dietary habits. Dietary habits including the use of dietary supplements have been the focus in the management of cardiovascular disease, and there is sufficient evidence that certain types of dietary habits or dietary supplements have positive or negative effects on CVD health, since people consume foods with complex combination of nutrients. While assessing overall dietary intake may show greater associations with health outcomes, diet supplementation with therapeutic components may also be an effective alternative to decrease CVD. On the one hand, not many studies have been conducted in a free-eating middle-age and elderly Taiwanese population. In addition, studies on dietary patterns have either used a-priori or a-posteriori methods to derive dietary patterns of a population, hence limited literature on the use of both methods in the same population. On the other hand, while a number of dietary supplements have been associated with a reduction of primary cardiovascular risk factors, such as fish oil and spirulina, these supplements have only been evaluated individually on the primary risk factors of CVD, and there are no evidences that directly link their combined effect in preventing diet-induced hypercholesterolemia. In light of this, this study therefore, will determine the association between dietary patterns and cardiovascular risk factors in middle-aged and elderly population in Taiwan, using both a-priori and a-posteriori methods to derive the dietary patterns. And also, determine the effects of single treatment with fish oil and spirulina or in combination (Fish oil and spirulina) on lipid profiles, inflammation, and antioxidant status in hamsters fed a hypercholesterolemic diet.

Methods: We created three dietary patterns: 1) a priori using an “a priori diet quality score” that was based on hypothesized healthfulness of foods (a priori dietary pattern), 2) An empirical derived dietary pattern that reflected a high intake of fruits and vegetables (Vegi-fruits dietary pattern) and 3) An empirical derived dietary pattern that reflected a high intake of meat and processed foods (meat-processed dietary pattern). The dietary patterns were divided into quintiles of consumption and assessed continuously. While general linear regression was used to assess associations between dietary patterns and the CVD biomarkers: lipids (Total cholesterol, triacylglycerols, LDL cholesterol, HDL cholesterol), inflammatory marker (CRP), and fasting glucose, logistic regression was used to assess the associations between dietary patterns and weight status. In addition in determining the effect of fish oil and spirulina, the hamsters were divided into 7 groups: control, high cholesterol (HF), fish oil (post FO), spirulina (post SP), and a combination of fish oil and spirulina (post SF, pre-SF, and HF+SF) groups. The HF and HF+SF groups were given a high cholesterol diet for 8 weeks. The post FO, post SP, and post SF groups were given a high cholesterol diet for 4 weeks and then the treatment for 4 weeks. The pre-SF group was given the combined treatment for 4 weeks and then a high cholesterol diet for 4 weeks. At the end of the experiment period, lipids, lipid peroxidation, antioxidant status in plasma and inflammation biomakers were determined.

Results and Conclusions: Generally, dietary patterns rich in fruits and vegetables had a negative association with CVD risk factors while patterns high in meat and processed foods had a positive association with CVD risk factors. This suggests that vegetables and fruits are beneficial in the management of CVD risk factors. While single treatments with fish oil and spirulina inhibited oxidative stress and inflammation, fish oil alone increased plasma lipids. However, only a combination of fish oil and spirulina (post SF) inhibited oxidative stress and regulated inflammation. Hence it may be beneficial for diet induced hypercholesterolemia.

並列關鍵字

Dietary patterns ； A priori ； A posteriori ； Cardiovascular disease ； CVD biomarkers ； Body mass index ； Underweight ； Overweight ； Obesity ； Hypercholesterolemia ； Spirulina ； Fish oil ； Oxidative stress ； Inflammation

參考文獻

Pan, W. H., Wu, H. J., Yeh, C. J., Chuang, S. Y., Chang, H. Y., Yeh, N. H., & Hsieh, Y. T. (2011). Diet and health trends in Taiwan: comparison of two nutrition and health surveys from 1993-1996 and 2005-2008. Asia Pac J Clin Nutr, 20(2), 238-250.

Lin, P. H., Yeh, W. T., Svetkey, L. P., Chuang, S. Y., Chang, Y. C., Wang, C., & Pan, W. H. (2013). Dietary intakes consistent with the DASH dietary pattern reduce blood pressure increase with age and risk for stroke in a Chinese population. Asia Pac J Clin Nutr, 22(2), 482-491. doi:10.6133/apjcn.2013.22.3.05

Willett, W. C., & McCullough, M. L. (2008). Dietary pattern analysis for the evaluation of dietary guidelines. Asia Pac J Clin Nutr, 17(S1), 75-78.

Lyu, L. C., Lin, C. F., Chang, F. H., Chen, H. F., Lo, C. C., & Ho, H. F. (2007). Meal distribution, relative validity and reproducibility of a meal-based food frequency questionnaire in Taiwan. Asia Pac J Clin Nutr, 16(4), 766-776.

Mirmiran, P., Bahadoran, Z., Golzarand, M., Rajab, A., & Azizi, F. (2013). Ardeh (Sesamum indicum) could improve serum triglycerides and atherogenic lipid parameters in type 2 diabetic patients: a randomized clinical trial. Arch Iran Med, 16(11), 651-656. doi:0131611/AIM.008