Advance in Epidemiologic Studies of Dietary Patterns Associated with Cerebrovascular Diseases

doi:10.12114/j.issn.1007-9572.2023.0565

Abstract

Abstract:

Stroke has become the leading cause of death in China, and rational diet is an important primary prevention strategy, but the optimal dietary pattern remains to be studied. Based on this, this paper reviews the progress of epidemiological studies on the correlation of Mediterranean Diet (MD) , Dietary Approaches to Stop Hypertension (DASH) pattern, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, Japanese dietary pattern and Chinese diet pattern with cerebrovascular diseases, and suggests that MD pattern, DASH pattern and Japanese dietary pattern have protective effects on cerebrovascular disease; however, the relationship between MIND pattern and cerebrovascular disease remains uncertain. There is a lack of large-scale randomized controlled trials to examine the effect of traditional Chinese dietary pattern on cerebrovascular diseases. In the future, active efforts in exploring the healthy dietary patterns in line with local dietary habits are needed for providing a Chinese strategy for primary stroke prevention.

Key words: Stroke, Dietary pattern, Diet, food, and nutrition, Epidemiological studies, Clinical trial, Review

摘要：

脑卒中已成为导致我国居民死亡的第一位死因，合理饮食是重要的一级预防策略，但采用何种膳食模式更优仍有待研究。基于此，本文综述地中海膳食模式（MD膳食模式）、得舒膳食模式（DASH膳食模式）、健脑膳食模式（MIND膳食模式）、日本膳食模式以及中国膳食模式与脑血管疾病相关的流行病学研究进展，得出已有大量流行病学研究提示MD膳食模式、DASH膳食模式、日本膳食模式对脑血管疾病具有保护作用；而MIND膳食模式与脑血管疾病的相关性仍待进一步研究提供相应证据。目前尚未有大规模的随机对照试验评价中国传统膳食模式对脑血管疾病的作用，学者在未来需积极探索符合国人本土饮食习惯的健康膳食模式，为脑卒中一级预防提供中国方案。

关键词: 卒中, 膳食模式, 膳食，食品和营养, 流行病学研究, 临床试验, 综述

CHEN Wenjin,CHEN Piaoying,YANG Xiaohua, et al. Advance in Epidemiologic Studies of Dietary Patterns Associated with Cerebrovascular Diseases[J]. Chinese General Practice, 2024, 27(08): 900-907. DOI: 10.12114/j.issn.1007-9572.2023.0565.
陈玟瑾,陈飘盈,杨晓华等. 膳食模式与脑血管疾病相关的流行病学研究新进展[J]. 中国全科医学, 2024, 27(08): 900-907. DOI: 10.12114/j.issn.1007-9572.2023.0565.

Figures/Tables 1

References 59

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膳食成分	MD膳食模式^[9]	DASH膳食模式^[56]	MIND膳食模式^[25]	日本膳食模式^[37]	中国居民平衡膳食^[51]
水果	1~2份/餐	4~5次/d	沙拉≥1份/d	≥1.8份/d	200~350 g/d
蔬菜	≥2份/餐	4~5次/d	其他蔬菜≥1份/d	≥5.4份/d	300~500 g/d
谷物	1~2份/餐（最好是全谷物）	7~8次/d	全谷物≥3份/d	米饭≥3碗/d	谷类200~300 g/d
					（全谷物和杂豆50~150 g/d）
					薯类50~100 g/d
奶及奶制品	2份/d	2~3次/d （低脂或无脂）	奶酪≤1份/周		300~500 g/d
豆类	≥2份/周	坚果、种子和豆类4~5次/周	≥1份/2 d	豆制品≥6次/周	大豆及坚果类25~35 g/d
橄榄、坚果、种子	1~2份/d	坚果、种子和豆类4~5次/周	坚果是大多数时的零食		大豆及坚果类25~35 g/d
肉类和肉制品	红肉<2份/周	瘦肉、家禽和鱼≤2次/d	家禽≥2次/周	<4次/周	动物性食物120~200 g/d（水产品≥2次/周，鸡蛋1个/d）
	白肉2份/周
	加工肉类≤1份/周
鱼/海产品	≥2份/周		鱼≥1次/周	鱼≥7次/周
蛋类	2~4份/周
脂肪、油		脂肪和油2~3次/d	黄油≤1汤匙/d		油25~30 g/d
甜食	≤2份/周	≤5次/周		日式甜品≥2.5次/周
其他	土豆≤3份/周	盐<2 300 mg/d	浆果≥2次/周	味噌汤≥2碗/d	水1 500~1 700 mL/d
	规律的体育活动		油炸食品≤1份/周	绿茶≥2杯/d	盐<5 g/d
	充足的休息		快餐≤1份/周	泡菜/腌制品≥6次/周	每天活动6 000步
	当地和环保产品烹饪活动		酒≥1份/d	海藻≥5次/周
	生物多样性和季节性传统			蘑菇≥5次/周
对脑血管疾病的作用	降低脑卒中发病风险	降低脑卒中发病风险	降低脑卒中发病风险、改善卒中后认知功能障碍	降低脑卒中发病风险	尚不清楚
证据来源	伞形综述、系统评价、随机对照试验、队列研究	伞形综述、系统评价、队列研究	少量队列研究、病例对照研究	系统评价、大量队列研究	指南/专家共识

膳食成分	MD膳食模式^[9]	DASH膳食模式^[56]	MIND膳食模式^[25]	日本膳食模式^[37]	中国居民平衡膳食^[51]
水果	1~2份/餐	4~5次/d	沙拉≥1份/d	≥1.8份/d	200~350 g/d
蔬菜	≥2份/餐	4~5次/d	其他蔬菜≥1份/d	≥5.4份/d	300~500 g/d
谷物	1~2份/餐（最好是全谷物）	7~8次/d	全谷物≥3份/d	米饭≥3碗/d	谷类200~300 g/d
					（全谷物和杂豆50~150 g/d）
					薯类50~100 g/d
奶及奶制品	2份/d	2~3次/d （低脂或无脂）	奶酪≤1份/周		300~500 g/d
豆类	≥2份/周	坚果、种子和豆类4~5次/周	≥1份/2 d	豆制品≥6次/周	大豆及坚果类25~35 g/d
橄榄、坚果、种子	1~2份/d	坚果、种子和豆类4~5次/周	坚果是大多数时的零食		大豆及坚果类25~35 g/d
肉类和肉制品	红肉<2份/周	瘦肉、家禽和鱼≤2次/d	家禽≥2次/周	<4次/周	动物性食物120~200 g/d（水产品≥2次/周，鸡蛋1个/d）
	白肉2份/周
	加工肉类≤1份/周
鱼/海产品	≥2份/周		鱼≥1次/周	鱼≥7次/周
蛋类	2~4份/周
脂肪、油		脂肪和油2~3次/d	黄油≤1汤匙/d		油25~30 g/d
甜食	≤2份/周	≤5次/周		日式甜品≥2.5次/周
其他	土豆≤3份/周	盐<2 300 mg/d	浆果≥2次/周	味噌汤≥2碗/d	水1 500~1 700 mL/d
	规律的体育活动		油炸食品≤1份/周	绿茶≥2杯/d	盐<5 g/d
	充足的休息		快餐≤1份/周	泡菜/腌制品≥6次/周	每天活动6 000步
	当地和环保产品烹饪活动		酒≥1份/d	海藻≥5次/周
	生物多样性和季节性传统			蘑菇≥5次/周
对脑血管疾病的作用	降低脑卒中发病风险	降低脑卒中发病风险	降低脑卒中发病风险、改善卒中后认知功能障碍	降低脑卒中发病风险	尚不清楚
证据来源	伞形综述、系统评价、随机对照试验、队列研究	伞形综述、系统评价、队列研究	少量队列研究、病例对照研究	系统评价、大量队列研究	指南/专家共识