饮食在预防动脉粥样硬化进展中的重要性。

Q2 Medicine
Voprosy pitaniia Pub Date : 2024-01-01 Epub Date: 2024-12-12 DOI:10.33029/0042-8833-2024-93-6-16-26
R N Mustafin, E A Galieva
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引用次数: 0

摘要

心血管疾病最常见的发病机制是动脉粥样硬化,由遗传易感性、高脂血症、炎症和代谢紊乱引起。他汀类药物可抑制内源性胆固醇合成,但其特点是有致糖尿病作用,9.1%的患者出现不耐受,10-25%的患者出现肌肉症状。因此,合理选择饮食对预防动脉粥样硬化非常重要。这项研究的目的是总结在食物的帮助下预防动脉粥样硬化发生和发展的可能性的现代概念。材料和方法。利用PubMed、Scopus、Web of Science、谷歌Scholar、ResearchGate和RSCI数据库,通过关键词“动脉粥样硬化”、“营养作用”、“素食者”、“地中海饮食”、“纯素饮食”、“植物性食物”、“致动脉粥样硬化食物”、“抗动脉粥样硬化食物”、“他汀类药物”、“副作用”、“并发症”进行文献检索,以确定饮食在动脉粥样硬化机制中的意义。结果。文献资料分析表明,生、熟(未油炸)植物制品及其成分具有抗动脉粥样硬化作用,影响动脉粥样硬化发病的各个环节。浆果、茶叶、水果和蔬菜中含有的多酚可降低低密度脂蛋白、促炎细胞因子,抑制血小板聚集,使内皮状态正常化。荟萃分析结果表明,ω-3多不饱和脂肪酸、大豆蛋白、姜黄、辣椒和维生素d的摄入可以抑制动脉粥样硬化的发展。水溶性和不溶性膳食纤维可以吸附胆固醇,减少其吸收,并有助于肠道微生物群的抗动脉粥样硬化特性。发酵乳制品、益生菌和益生元促进肠道菌群合成低脂物质。富含胆固醇、铁和糖的食物,任何油炸食品,不管使用的脂肪,食用含有磷酸盐和钙作为食品添加剂的食物,都会促进动脉粥样硬化的发展。结论。合理的饮食疗法有助于预防动脉粥样硬化,这对他汀类药物不耐受或有禁忌症的患者尤其重要。在选择饮食方面需要综合的方法,限制富含胆固醇的食物,适当的烹饪而不是油炸,吃有抗动脉粥样硬化作用的食物。基于植物产品中所含的生物活性化合物的新药研究是有希望的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The importance of the diet in the prevention of atherosclerosis progression].

The most common mechanism of the development of cardiovascular diseases is atherosclerosis, caused by genetic predisposition, hyperlipidemia, inflammation and metabolic disorders. Statins used in medicine inhibit endogenous cholesterol synthesis, but are characterized by diabetogenic effect, development of intolerance in 9.1%, and muscle symptoms in 10-25% of patients. Therefore, a well-chosen diet is important in atherosclerosis preventing. The aim of the research was to summarize modern concepts on the possibilities of preventing the development and progression of atherosclerosis with the help of food. Material and methods. A literature search to determine the significance of diet in atherosclerosis mechanisms was conducted using the PubMed, Scopus, Web of Science, Google Scholar, ResearchGate, and RSCI databases by keywords "atherosclerosis", "nutrition effects", "vegetarians", "mediterranean diet", "vegan diet", "plant food", "atherogenic food", "antiatherogenic food", "statins", "side effects", «complications». Results. The analysis of literature data showed that raw and cooked (unfried) plant products and their components have an anti-atherosclerotic effect, which affects various links in atherosclerosis pathogenesis. Polyphenols contained in berries, tea, fruit and vegetables reduce low-density lipoproteins, pro-inflammatory cytokines, suppress platelet aggregation, and normalize endothelium state. The results of meta-analyses indicate suppression of atherosclerosis development with the consumption of ω-3 polyunsaturated fatty acids, soy protein, turmeric, hot peppers, and vitamin D. Water-soluble and insoluble dietary fibers adsorb cholesterol, reduce its absorption and contribute to anti-atherogenic properties of intestinal microflora. Fermented dairy products, probiotics and prebiotics potentiate the synthesis of hypolipidogenic substances by the intestinal microbiota. The development of atherosclerosis is promoted by food rich in cholesterol, iron and sugar, any fried foods regardless of the fats used, consumption of foods containing phosphates and calcium as food additives. Conclusion. The use of competent diet therapy helps prevent atherosclerosis, which is especially important for patients with intolerance or contraindications to statin use. A comprehensive approach is needed in choosing the diet with limiting cholesterol-rich foods, and proper cooking without frying in oil, eating foods with antiatherogenic action. The search for new medicines based on bioactive compounds contained in plant products is promising.

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Voprosy pitaniia
Voprosy pitaniia Medicine-Medicine (all)
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