中国全科医学 ›› 2023, Vol. 26 ›› Issue (13): 1568-1576.DOI: 10.12114/j.issn.1007-9572.2022.0753

所属专题: 神经退行性病变最新文章合集 营养最新文章合集

• 论著·脑健康专题研究 • 上一篇    下一篇

促进社区居民脑健康的膳食营养管理最佳证据总结

刘晓, 张巾英, 彭滟, 王黎, 陈晓梅, 刘佳, 邓梦惠, 杨燕妮*()   

  1. 400038 重庆市,陆军军医大学护理系基础护理学教研室
  • 收稿日期:2022-10-14 修回日期:2023-01-27 出版日期:2023-05-05 发布日期:2023-02-23
  • 通讯作者: 杨燕妮

  • 作者贡献:刘晓、张巾英、彭滟、杨燕妮负责文章的选题与设计;刘晓、张巾英负责文献检索;刘晓、彭滟负责文献质量评价;刘晓、张巾英、彭滟、王黎负责证据汇总;刘晓负责论文撰写;陈晓梅、刘佳、邓梦惠负责论文的修订;杨燕妮负责研究设计、研究经费的获取、论文写作指导、文章的质量控制及审校,并对文章整体负责。
  • 基金资助:
    国家社会科学基金项目(20BRK039)

Summary of the Best Evidence for Dietary Nutrients Management to Promote Brain Health in Community-dwelling Residents

LIU Xiao, ZHANG Jinying, PENG Yan, WANG Li, CHEN Xiaomei, LIU Jia, DENG Menghui, YANG Yanni*()   

  1. Department of Basic Nursing, School of Nursing, Army Medical University, Chongqing 400038, China
  • Received:2022-10-14 Revised:2023-01-27 Published:2023-05-05 Online:2023-02-23
  • Contact: YANG Yanni

摘要: 背景 保持脑健康是健康老龄化的高阶目标,合理膳食营养被认为是有望降低痴呆风险的重要途径之一,但目前临床上缺乏具体化、全面性的促进社区居民脑健康的膳食营养管理方案,导致医务人员对社区居民的相关健康指导缺失或不足。 目的 检索、评价并总结促进社区居民脑健康的膳食营养管理相关证据,为临床开展旨在促进社区居民脑健康的膳食营养管理工作提供依据。 方法 于2022年3月,计算机检索UpToDate、BMJ最佳临床实践、乔安娜布里格斯研究所(JBI)循证卫生保健中心数据库、美国国立老化研究所(NIA)网站、加拿大安大略省注册护士协会(RNAO)网站、the Cochrane Library、PubMed、中国知网、医脉通等数据库和网站,获取促进社区居民脑健康的膳食营养管理相关文献,文献类型包括临床决策、推荐实践、指南、证据总结、专家共识、系统评价,检索时限均为2017-01-01至2022-03-29。由2名接受过系统循证医学培训的研究者独立筛选文献、提取资料并对纳入的文献进行质量评价后,从符合质量标准的文献中提取证据,并对证据进行质量分级,总结促进社区居民脑健康的膳食营养管理最佳证据。 结果 共纳入28篇文献,包括3篇指南,5篇专家共识,1篇临床决策,19篇系统评价;纳入文献总体质量较高。从干预时机、膳食营养评估和筛查、膳食模式及成分、特定营养素、咖啡摄入、体质量管理、健康教育及指导7个方面共汇总23条最佳证据。 结论 合理膳食营养对居民保持脑健康有促进作用,社区医务人员应结合临床情境、居民膳食营养现状与选择偏好、最佳证据,为居民制定个体化、促进其脑健康的膳食营养管理方案。

关键词: 脑健康, 痴呆, 膳食,食品和营养, 膳食,健康, 社区卫生服务, 证据总结, 循证医学

Abstract:

Background

Maintaining brain health is an advanced goal of healthy ageing. Eating a diet with appropriate nutrients has been identified as a promising approach to reducing the risk of dementia, but community-dwelling residents have inadequate or no health guidance from medical workers since there is no detailed and comprehensive clinical dietary nutrients management program for brain health promotion for community-dwelling people .

Objective

To search, evaluate and summarize the evidence on dietary nutrients management for brain health promotion in community-dwelling people, providing an evidence-based basis for clinical implementation of such management for this group of population.

Methods

In March 2022, we searched UpToDate, BMJ Best Practice, JBI Model of Evidence-based Healthcare, National Institute on Aging, Registered Nurses' Association of Ontario, the Cochrane Library, PubMed, CNKI, Medlive and other databases to collect literature (involving clinical decisions, recommended practices, guidelines, evidence summaries, expert consensuses and systematic reviews) regarding dietary nutrients management for brain health promotion in community-dwelling people. The retrieval period was from January 1, 2017 to March 29, 2022. Two researchers systematically trained in evidence-based medicine independently screened literature, extracted data, and evaluated the quality of the included literature. Then evidence was extracted from the included literature, and its quality was graded, then the best evidence was summarized.

Results

A total of 28 studies with an overall high methodological quality were included, including three clinical guidelines, five expert consensuses, one clinical decision and 19 systematic reviews. Finally, 23 pieces of best evidence were summarized, involving seven aspects of intervention timing, dietary nutrients assessment and screening, dietary patterns and components, specific nutrients, coffee intake, body weight management, health education and guidance.

Conclusion

Eating a diet with appropriate nutrients can promote brain health of residents. Community medical workers should develop an individualized dietary nutrients management program for brain health for them in accordance with the practical clinical situation, residents' current dietary nutrients status and preferences, and insights from the best evidence.

Key words: Brain health, Dementia, Diet, food, and nutrition, Diet, healthy, Community health services, Evidence summaries, Evidence-based medicine