Abstract: Objective　To investigate the mechanism of action of nutritional ingredients in blood control based on the study of using modified dietary pattern for improving the blood pressure，body composition and blood lipid profile conducted in overweight or obese middle-aged and older people from Zhangfang Village of Beijing's Fangshan District combined with our previous studies.Methods　This trial was conducted from May 21st to July 1st，2017.From the database of middle-aged and older villagers（245 cases aged 45-75）of Zhangfang Village of Beijing's Fangshan District，54 overweight or obese cases with grade 1 hypertension were selected based on the inclusion and exclusion criteria and were randomized into group A（n=27）eating standardized balanced diet and group B（n=27）eating standardized balanced diet supplemented by anti-atherosclerotic powdered foods.Then，according to the completion status of trial，30（15 in group A and 15 in group B）were included in the final analysis.We collected their data concerning blood pressure〔including systolic blood pressure（SBP）and diastolic blood pressure（DBP）〕，body composition〔including body mass index（BMI），body fat percentage（BFP），body fat mass（BFM），waist-to-hip ratio（WHR）and visceral fat area（VFA）〕，blood lipid profile〔including total cholesterol（TC），triacylglycerol（TG），high-density lipoprotein cholesterol（HDL-C）and low density lipoprotein cholesterol（LDL-C）〕measured before the trial（T0），at the end of the second week（T1），at the end of the fourth week（T2）and total energy intake，food intake（including staple food，leafy vegetables，rhizome vegetables，salt，edible oil，eggs，milk，red meat，white meat，tofu，fruit），nutrient intake/ratio〔including carbohydrates，proteins，fat，dietary fiber，vitamin A（VitA），vitamin B1（VitB1），vitamin B2（VitB2），vitamin C（VitC），calcium，iron，zinc，selenium，magnesium，manganese，cholesterol，nicotinic acid，folic acid，saturated fatty acids（SFA），monounsaturated fatty acids（MUSF）and polyunsaturated fatty acids（PUFA）〕before and after intervention.Results　SBP decreased significantly at T1，and DBP and SBP decreased significantly at T2 in both groups compared with at T0（P<0.05）.Group A showed less BMI，BFM and VFA and higher HDL-C at T1，and demonstrated less BFM，WHR and VFA at T2 compared with at T0（P<0.05）.Furthermore，group A presented less WHR，TC，HDL-C and LDL-C but greater VFA at T2 compared with at T1（P<0.05）.In contrast，group B exhibited less BMI，BFP，BFM，VFA and TG but higher HDL-C at T1，and demonstrated less BMI，BFP，BFM，WHR and VFA，but higher HDL-C at T2 compared with at T0（P<0.05）.Furthermore，group B presented lower HDL-C but greater VFA and higher TG at T2 compared with at T1（P<0.05）.Before and after intervention，both groups showed no significant difference in the average total energy intake（P>0.05）.The average total energy intake after intervention was not significantly different from that before intervention in both groups（P>0.05）.The average intake of edible oil before intervention in group B was higher than that in group A（P<0.05）.Compared with before intervention，except the average intake of salt and edible oil decreased obviously，the average intake of leafy vegetables，rhizome vegetables，eggs，milk，white meat，tofu and fruit increased significantly in both groups after intervention，as did that of protein，dietary fiber，VitA，VitB1，VitB2，VitC，calcium，iron，zinc，magnesium，manganese，cholesterol，nicotinic acid，folic acid，SFA，PUFA and the protein percentage in daily food intake（P<0.05）.The fat percentage in daily food intake declined substantially in group B after intervention（P<0.05）.Compared with group A，the average intake of carbohydrates and selenium was much less but that of protein，magnesium and manganese was much more in group B after intervention（P<0.05）.Conclusion　After eating the balanced diet and modified balanced diet（by adding anti-atherosclerotic powdered foods），the participants developed a comparatively healthy dietary pattern，then，their body composition was improved，blood lipid was stabilized，and the blood pressure was significantly reduced.

Key words: Hypertension, Diet, Body composition, Lipid profile

摘要： 目的　在前期研究基础上，观察再次改善膳食模式对北京市房山区张坊村中老年超重或肥胖高血压患者血压、人体成分、血脂谱的影响，探讨营养成分通过改变人体成分、血脂谱，从而对血压产生影响的可能机制。方法　2017-05-21至2017-07-01，根据纳入与排除标准，从北京市房山区张坊村245例中老年（45~75岁）村民数据库中，选取超重或肥胖的1级高血压患者54例为研究对象。采用随机数字表法将其分为A组（27例，采用标准均衡膳食）和B组（27例，采用补充抗动脉粥样硬化食疗粉的均衡膳食）。按照剔除标准，最终共纳入30例患者，其中A组15例，B组15例。分别记录患者干预前（T0）、干预中（T1）、干预结束（T2）时血压（收缩压、舒张压）、人体成分〔体质指数（BMI）、体脂含量（BF）、体脂肪量、腰臀比（WHR）、内脏脂肪面积〕、血脂谱〔总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）〕及干预前后总能量摄入量、各类食物（主食、叶菜类蔬菜、根茎类蔬菜、盐、食用油、鸡蛋、全脂牛奶、红色肉类、白色肉类、豆腐、水果）摄入量、营养素〔碳水化合物、蛋白质、脂肪、膳食纤维、维生素A（VitA）、维生素B1（VitB1）、维生素B2（VitB2）、维生素C（VitC）、钙、铁、锌、硒、镁、锰、胆固醇、烟酸、叶酸、饱和脂肪酸（SFA）、单不饱和脂肪酸（MUSF）和多不饱和脂肪酸（PUFA）〕摄入量/比例。结果　A组、B组T1、T2时收缩压均低于T0时，T2时舒张压均低于T0时（P<0.05）。A组T1时BMI、体脂肪量、内脏脂肪面积低于T0时，T2时体脂肪量、WHR、内脏脂肪面积低于T0时，T2时WHR低于T1时，T2时内脏脂肪面积高于T1时（P<0.05）；B组T1时BMI、BF、体脂肪量、内脏脂肪面积低于T0时，T2时BMI、BF、体脂肪量、WHR、内脏脂肪面积低于T0时，T2时内脏脂肪面积高于T1时（P<0.05）。A组T2时TC、HDL-C、LDL-C低于T1时，T1时HDL-C高于T0时（P<0.05）；B组T1时TG低于T0时、HDL-C高于T0时，T2时HDL-C高于T0时、TG高于T1时、HDL-C低于T1时（P<0.05）。两组干预前、干预后总能量摄入量比较，差异无统计学意义（P>0.05）；A组、B组干预后总能量摄入量与同组干预前比较，差异无统计学意义（P>0.05）。B组干预前食用油摄入量高于A组（P<0.05）。A组、B组干预后叶菜类蔬菜、根茎类蔬菜、鸡蛋、全脂牛奶、白色肉类、豆腐、水果摄入量高于同组干预前，盐、食用油摄入量低于同组干预前（P<0.05）。B组干预后碳水化合物、硒摄入量低于A组，蛋白质、镁、锰摄入量高于A组（P<0.05）。A组、B组干预后蛋白质、膳食纤维、VitA、VitB1、VitB2、VitC、钙、铁、锌、镁、锰、胆固醇、烟酸、叶酸、SFA、PUFA摄入量及蛋白质摄入比例高于同组干预前（P<0.05）；B组干预后脂肪摄入比例低于干预前，硒摄入量高于干预前（P<0.05）。结论　对北京市房山区张坊村中老年超重或肥胖高血压患者给予标准均衡膳食和补充抗动脉粥样硬化食疗粉的均衡膳食后，其膳食模式得以改善，进而优化人体成分，平稳血脂水平，显著降低血压。

关键词: 高血压, 膳食, 人体成分, 血脂