低醣高油高蛋白飲食不會比低油高醣飲食造成更多心臟病風險

低油飲食一向被認為可減少心臟病風險,相反的低醣高油則被認為會增加心臟病風險。但是最近哈佛大學的研究推翻了這種說法,低醣高油及高蛋白飲食不但不會比低油高醣飲食增加更多心臟病風險,反而如果增加的是植物性脂肪及蛋白質還能比低油高醣飲食降低心臟病風險。

NEW ENGLAND JOURNAL OF MEDICINE
Volume 355:1991-2002
November 9, 2006
Number 19

Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women

Thomas L. Halton, Sc.D., Walter C. Willett, M.D., Dr.P.H., Simin Liu, M.D., Sc.D., JoAnn E. Manson, M.D., Dr.P.H., Christine M. Albert, M.D., M.P.H., Kathryn Rexrode, M.D., and Frank B. Hu, M.D., Ph.D.

ABSTRACT
Background Low-carbohydrate diets have been advocated for weight loss and to prevent obesity, but the long-term safety of these diets has not been determined.
Methods We evaluated data on 82,802 women in the Nurses’ Health Study who had completed a validated food-frequency questionnaire. Data from the questionnaire were used to calculate a low-carbohydrate-diet score, which was based on the percentage of energy as carbohydrate, fat, and protein (a higher score reflects a higher intake of fat and protein and a lower intake of carbohydrate). The association between the low-carbohydrate-diet score and the risk of coronary heart disease was examined.
Results During 20 years of follow-up, we documented 1994 new cases of coronary heart disease. After multivariate adjustment, the relative risk of coronary heart disease comparing highest and lowest deciles of the low-carbohydrate-diet score was 0.94 (95% confidence interval [CI], 0.76 to 1.18; P for trend=0.19). The relative risk comparing highest and lowest deciles of a low-carbohydrate-diet score on the basis of the percentage of energy from carbohydrate, animal protein, and animal fat was 0.94 (95% CI, 0.74 to 1.19; P for trend=0.52), whereas the relative risk on the basis of the percentage of energy from intake of carbohydrates, vegetable protein, and vegetable fat was 0.70 (95% CI, 0.56 to 0.88; P for trend=0.002). A higher glycemic load was strongly associated with an increased risk of coronary heart disease (relative risk comparing highest and lowest deciles, 1.90; 95% CI, 1.15 to 3.15; P for trend=0.003).
Conclusions Our findings suggest that diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. When vegetable sources of fat and protein are chosen, these diets may moderately reduce the risk of coronary heart disease.

Source Information
From the Departments of Nutrition (T.L.H., W.C.W., F.B.H.) and Epidemiology (W.C.W., J.E.M., F.B.H.), Harvard School of Public Health, Boston; the Department of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles (S.L.); and the Division of Preventive Medicine (J.E.M., C.M.A., K.R.), the Channing Laboratory (W.C.W., J.E.M., K.R., F.B.H.), and the Cardiovascular Division (C.M.A.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston.

 

意義:

  1. 此研究刊登在醫學界最頂尖的學術期刊,具公信力。
  2. 此研究是由哈佛大學所主導,研究對象超過八萬名婦女,歷時20年的追蹤,是非常大型的研究。
  3. 結果證實低醣高油高蛋白飲並非像一般所認知的會傷害心臟。
  4. 如果增加植物性脂肪及蛋白質還能降低心臟病風險。

 

解讀:

the relative risk of coronary heart disease comparing highest and lowest deciles of the low-carbohydrate-diet score was 0.94

吃最少油和蛋白質但吃最多醣類的這一組若發生心臟病為1人的話, 那吃最多油和蛋白質但吃最少醣類的這一組發生心臟病為0.94人,這意思是這兩組發生心臟病的機率差不多。

the relative risk of coronary heart disease comparing highest and lowest deciles of a low-carbohydrate-diet score on the basis of the percentage of energy from carbohydrate, animal protein, and animal fat was 0.94

吃最少油和蛋白質但吃最多醣類的這一組若發生心臟病為1人的話, 那吃最多動物油和動物蛋白質但吃最少醣類的這一組發生心臟病為0.94人,這意思是這兩組發生心臟病的機率差不多。

the relative risk of coronary heart disease comparing comparing highest and lowest deciles of a low-carbohydrate-diet score on the basis of the percentage of energy from intake of carbohydrates, vegetable protein, and vegetable fat was 0.70

吃最少油和蛋白質但吃最多醣類的這一組若發生心臟病為1人的話, 那吃最多植物油和植物蛋白質但吃最少醣類的這一組發生心臟病為0.7人,這意思是與低油高醣相比,增加植物油和植物蛋白質減少醣類可以減少30%心臟病。