Diet, Carbohydrate-Restricted

饮食,碳水化合物限制
  • 文章类型: Journal Article
    考虑到胰岛素抵抗在各种形式的癌症中的重要参与,据推测,实施糖尿病饮食,有效缓解胰岛素抵抗,可能会降低女性个体对乳腺癌的易感性。
    在这篇文献综述中,使用关键词\"乳腺癌\"或\"乳腺肿瘤\"或\"乳腺肿瘤\"和\"饮食\"或\"糖尿病饮食\"或\"低碳水化合物饮食\"或\"碳水化合物限制饮食\"或\"高蛋白低碳水化合物饮食\"或\"糖尿病风险降低饮食\"或\"DRRD\"作为主要关键词。
    研究表明,DRRD评分与乳腺癌风险呈负相关。事实上,DRRD分数每增加3分,患乳腺癌的风险降低7%。研究表明,乳腺癌患者的DRRD评分较高与癌症风险降低和生存机会较高相关。
    这项研究的结果表明,对降低糖尿病风险饮食(DRRD)的更高水平的依从性与提高的生存率之间存在正相关。这表明乳腺癌幸存者可能会在诊断后根据糖尿病饮食进行饮食调整而受益。
    UNASSIGNED: Considering the significant involvement of insulin resistance in various forms of cancer, it is postulated that the implementation of a diabetic diet, which effectively mitigates insulin resistance, may potentially decrease the susceptibility to breast cancer among female individuals.
    UNASSIGNED: In this literature review, a comprehensive electronic search of different databases was done using the keywords \"Breast cancer\" OR \"breast tumor\" OR \"Breast Neoplasms\" AND \"diet\" OR \"diabetic diet\" OR \"Low Carbohydrate Diet\" OR \"Carbohydrate restricted diet\" OR \"High-Protein Low-Carbohydrate Diet\" OR \"diabetes risk reduction diet\" OR \"DRRD\" as the main keywords.
    UNASSIGNED: Research has shown that the DRRD score is inversely correlated with breast cancer risk. In fact, for every three-point increase in the DRRD score, the risk of breast cancer decreases by 7%. Studies have shown that higher DRRD scores in breast cancer patients are associated with a reduced risk of cancer and a higher chance of survival.
    UNASSIGNED: The results of this study indicate a positive correlation between a higher level of adherence to the diabetes risk reduction diet (DRRD) and improved survival rates. This suggests that breast cancer survivors may benefit from making dietary modifications in line with a diabetic diet following their diagnosis.
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  • 文章类型: Journal Article
    目标:低可发酵寡头饮食,di-,单糖,和多元醇(LFD)已被证明可以有效减轻肠易激综合征(IBS)症状。由于现实世界中患者的多样性,现实世界研究产生的影响可能与疗效研究中看到的不同。这项系统评价和荟萃分析旨在比较LFD在疗效试验和现实世界研究中对减轻IBS症状和改善生活质量(QoL)的影响。
    方法:主要数据库,审判登记处,论文,并系统地检索了有关成人IBSLFD的研究期刊。使用具有标准化平均差异(SMD)和95%置信区间(CI)的随机效应模型进行荟萃分析。感兴趣的结果都是患者报告的:粪便稠度,大便频率,腹痛,总体症状,充分缓解症状,IBS特异性QoL和坚持LFD。
    结果:回顾了11项疗效和19项真实世界研究。腹痛(SMD0.35,95%CI0.16至0.54)和QoL(SMD0.23,95%CI-0.05至0.50)的荟萃分析结果显示,LFD在疗效研究中是有益的,大便频率无统计学意义(SMD0.71,95%CI0.34至1.07)。真实世界的研究发现腹痛和QoL有所改善。由于异质性,未对粪便稠度和总体症状进行荟萃分析.在这些结果中,结果大多支持LFD,但它们并不总是具有统计学意义。
    结论:本系统评价和荟萃分析的结果表明,与对照饮食(疗效研究)或基线数据(真实世界研究)相比,LFD改善了结局。由于不同的研究设计和结果的异质性,LFD相对于对照饮食的明显优势无法得出结论.没有迹象表明成人IBS患者的LFD存在疗效-疗效差距。
    OBJECTIVE: A diet low in fermentable oligo-, di-, monosaccharides, and polyols (LFD) has been shown to effectively reduce irritable bowel syndrome (IBS) symptoms. Effects resulting from real-world studies may differ from those seen in efficacy studies because of the diversity of patients in real-world settings. This systematic review and meta-analysis aimed to compare the effect of the LFD on reducing IBS symptoms and improving the quality of life (QoL) in efficacy trials and real-world studies.
    METHODS: Major databases, trial registries, dissertations, and journals were systematically searched for studies on the LFD in adults with IBS. Meta-analysis was conducted using a random effects model with standardized mean differences (SMD) and 95% confidence intervals (CI). Outcomes of interest were all patient-reported: stool consistency, stool frequency, abdominal pain, overall symptoms, adequate symptom relief, IBS-specific QoL and adherence to the LFD.
    RESULTS: Eleven efficacy and 19 real-world studies were reviewed. The meta-analysis results for abdominal pain (SMD 0.35, 95% CI 0.16 to 0.54) and QoL (SMD 0.23, 95% CI -0.05 to 0.50) showed the LFD was beneficial in efficacy studies with no statistically significant results for stool frequency (SMD 0.71, 95% CI 0.34 to 1.07). Real-world studies found improvements in abdominal pain and QoL. Due to heterogeneity, no meta-analysis was done for stool consistency and overall symptoms. In these outcomes, results were mostly supportive of the LFD, but they were not always statistically significant.
    CONCLUSIONS: The results of this systematic review and meta-analysis suggest the LFD improves outcomes compared to a control diet (efficacy studies) or baseline data (real-world studies). Because of diverse study designs and heterogeneity of results, a clear superiority of the LFD over control diets could not be concluded. There are no indications of an efficacy-effectiveness gap for the LFD in adults with IBS.
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  • 文章类型: Journal Article
    低FODMAP饮食(LFD)是控制肠易激综合征(IBS)症状的常见限制性饮食。然而,对于这种饮食的缓解效果没有共识。在这里,采用荟萃分析进行了系统综述,以研究LFD对患者IBS症状及其次要结局的影响。在以前的荟萃分析中没有报道。我们在PubMed进行了系统的文献检索,Scopus,和ISIWebofScience截至2023年12月。使用AMSTAR2和Cochrane偏倚风险评估系统综述及其纳入试验的方法学质量,分别。使用GRADE方法评估证据工具的确定性。与IBS症状相关的数据,生活质量(QoL),微生物组多样性,提取粪便短链脂肪酸。随机效应(如果RCTs≥6)或固定效应模型(如果RCTs<5)用于重新计算效应大小和95%CIs,并以定性和定量方式报告它们(合并风险比,对冲\'g,和加权平均差)。初步确定共658篇文章,11项荟萃分析和24项RCT报告28项结局,纳入1646名参与者.根据IBS-SSS问卷(RR:1.42;95%CI:1.02,1.97;P=0.04),在所有IBS亚型中,LFD显着影响总症状的临床改善,并且对大便稠度(WMD:-0.48;95%CI:-0.902,-0.07)和频率(WMD:-0.36;95%CI:-0.61,-0.10)以及其他症状均少于4周的这需要超过4周的LFD实施。观察到QoL显着改善,但在焦虑和抑郁状态下未见改善。此外,一些研究表明,LFD可能会增加粪便pH值和菌群失调,并降低SCFA和双歧杆菌的丰度。总之,LFD可以减轻IBS患者的症状和QoL,尽管可能会发生生态失调。考虑到证据的确定性低,需要具有更适当设计的强大RCT。
    A low FODMAP diet (LFD) is a common restrictive diet to manage the symptoms of irritable bowel syndrome (IBS). However, there is no consensus on the alleviating effects of this diet. Herein, a systematic umbrella review with meta-analysis was conducted to investigate the effect of an LFD on IBS symptoms and its secondary outcomes in patients, which were not reported in previous meta-analyses. We performed a systematic literature search in PubMed, Scopus, and ISI Web of Science up to December 2023. The methodological quality of systematic reviews and their included trials was evaluated using AMSTAR 2 and the Cochrane risk of bias, respectively. The certainty of the evidence tool was evaluated using the GRADE approach. The data related to IBS symptoms, quality of life (QoL), microbiome diversity, and stool short-chain fatty acids were extracted. A random-effect (if RCTs ≥ 6) or fixed-effect model (if RCTs < 5) was used to recalculate effect sizes and 95% CIs and report them in both qualitative and quantitative terms (pooled risk ratio, Hedges\' g, and weighted mean difference). A total of 658 articles were initially identified, with 11 meta-analyses and 24 RCTs reporting 28 outcomes with 1646 participants included. An LFD significantly affected the clinical improvement of total symptoms according to the IBS-SSS questionnaire (RR: 1.42; 95% CI: 1.02, 1.97; P = 0.04) in all the subtypes of IBS and also had favorable effects on stool consistency (WMD: -0.48; 95% CI: -0.902, -0.07) and frequency (WMD: -0.36; 95% CI: -0.61, -0.10) and some other GI symptoms in both less and more than 4 weeks of diet intervention except for stool consistency, which needed more than 4 weeks of LFD implementation. A significant QoL improvement was observed but not in the anxiety and depression state. Furthermore, some studies showed that an LFD may increase fecal pH and dysbiosis and reduce SCFA and the abundance of Bifidobacterium. In conclusion, an LFD can alleviate symptoms and QoL in IBS patients, although dysbiosis may occur. Considering the low certainty of evidence, strong RCTs with more appropriate designs are needed.
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  • 文章类型: Systematic Review
    母亲的饮食质量对于确保儿童成长和发育以及保持女性健康至关重要。本系统评价旨在确定哺乳期碳水化合物限制饮食的结果。PubMed,EMBASE,Scopus,WebofScience,和LILACS搜索了2012年至2023年发表的研究;选择了16项研究,所有这些病例报告或护理系列。论文中描述的碳水化合物限制主要是生酮,低碳水化合物,低碳水化合物和高脂肪,和改良生酮饮食。女性进行这些饮食的主要目标是减肥,仅有2例患者具有治疗目的(由卫生专业人员监测和监督):(1)生酮饮食治疗婴儿癫痫发作和(2)减轻母亲胃食管反流症状。大多数文章报道说哺乳期妇女住院,出现呕吐等症状,肌肉无力,恶心,腹痛,全身不适,和疲劳。然而,文章没有提到婴儿的不良结局.这篇综述中的大多数研究都是在过去的3年中发表的,表明在哺乳期限制碳水化合物的女性因身体不满而导致体重减轻的情况可能会增加。总之,哺乳期间的碳水化合物限制可能对哺乳期妇女有害,并导致泌乳酮症酸中毒的状态,但婴儿的结局主要是喂养方式的变化。因此,食品和营养教育对这个人口是必要的。
    The quality of a mother\'s diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a carbohydrate-restricted diet during lactation. PubMed, EMBASE, Scopus, Web of Science, and LILACS were searched for studies published between 2012 and 2023; 16 studies were selected, all of them case reports or care series. The carbohydrate restriction described in the papers mainly was ketogenic, low-carb, low-carbohydrate and high-fat, and modified ketogenic diets. The main goal of women undertaking these diets was weight loss, with therapeutic purposes (monitored and supervised by health professionals) in only 2 cases: (1) ketogenic diet therapy for treatment of seizures in the infant and (2) to reduce symptoms of mother\'s gastroesophageal reflux. Most articles reported that lactating women were hospitalized, experiencing symptoms such as vomiting, muscle weakness, nausea, abdominal pain, general malaise, and fatigue. However, articles did not mention poor outcomes for the infants. Most of the studies in this review were published in the past 3 years, indicating a possible increase in cases of women practicing carbohydrate restriction during lactation for weight loss caused by body dissatisfaction. In conclusion, carbohydrate restriction during lactation may be harmful to the lactating woman and contribute to the state of lactational ketoacidosis, but infant outcomes are mainly a change in feeding patterns. Thus, education on food and nutrition is necessary for this population.
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  • 文章类型: Journal Article
    2型糖尿病(T2DM)是一种高度流行的代谢性疾病,给全世界的医疗系统造成沉重负担,与相关的并发症和抗糖尿病药物处方。最近,研究表明,在超重和肥胖的个体中,使用低碳水化合物饮食(LCD)和极低能量饮食(VLED)可以通过显著的体重减轻来缓解T2DM.临床试验显示缓解率为25-77%,和代谢改善,如改善血脂和血压。相比之下,临床试验表明,缓解率随着时间的推移而下降,同时体重增加,或体重减轻。这篇综述旨在讨论有关T2DM长期缓解的潜在决定因素的现有文献,包括对体重减轻的代谢适应(例如,胃肠激素的作用),饮食干预的类型(即,LCD或VLED),维持β(β)细胞功能,早期血糖控制,和社会心理因素。这篇叙述性综述很重要,因为确定与维持长期缓解的挑战相关的因素可能有助于设计2型糖尿病缓解的可持续干预措施。
    Type 2 diabetes mellitus (T2DM) is a highly prevalent metabolic disease, causing a heavy burden on healthcare systems worldwide, with related complications and anti-diabetes drug prescriptions. Recently, it was demonstrated that T2DM can be put into remission via significant weight loss using low-carbohydrate diets (LCDs) and very low-energy diets (VLEDs) in individuals with overweight and obesity. Clinical trials demonstrated remission rates of 25-77%, and metabolic improvements such as improved blood lipid profile and blood pressure were observed. In contrast, clinical trials showed that remission rate declines with time, concurrent with weight gain, or diminished weight loss. This review aims to discuss existing literature regarding underlying determinants of long-term remission of T2DM including metabolic adaptations to weight loss (e.g., role of gastrointestinal hormones), type of dietary intervention (i.e., LCDs or VLEDs), maintaining beta (β)-cell function, early glycemic control, and psychosocial factors. This narrative review is significant because determining the factors that are associated with challenges in maintaining long-term remission may help in designing sustainable interventions for type 2 diabetes remission.
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  • 文章类型: Journal Article
    低碳水化合物饮食(LCD)由于其对健康结果的有利影响而引起了人们的兴趣,比如炎症。然而,需要进一步的研究来确定LCD对炎症参数的总体影响,但同时要考虑减肥和热量摄入。因此,对随机临床试验进行了系统评价和荟萃分析,以研究LCD与低脂饮食(LFDs)相比的效果。有和没有热量限制,成人炎症标志物。PubMed,Scopus,和WebofScience在2022年3月进行了搜索,以选择针对LCD和LCD的干预研究LFD,其中使用了以下循环炎症标志物:C反应蛋白(CRP),肿瘤坏死因子α(TNF-α),和白细胞介素(IL-6)。进行了比较LCD与LCD的分析。使用随机效应模型通过加权平均差(WMD)或标准化平均差(SMD)和95%置信区间(95%CIs)进行LFD。系统评价和荟萃分析共包括51项研究,总样本为4,164名成年人,有或没有其他慢性疾病。干预持续时间为2-144周。LCD,与LFD相比,体重显著下降[WMD=-1.35%,p=0.001],CRP[SMD=-0.1,p=0.03],和IL-6[SMD=-0.15,p=0.09]。然而,与LFD相比,LCD没有显着降低TNF-α[SMD=-0.02,p=0.7]。总之,LCD通过降低CRP和IL-6对炎症标志物具有有益作用;这种作用与体重减轻有关。然而,LCD在降低TNF-α方面并不比LFD更有效。
    Low-carbohydrate diets (LCDs) have gained interest due to their favorable effects on health outcomes, such as inflammation. However, further research is needed to ascertain the overall effects of LCDs on inflammatory parameters, but at the same time considering weight loss and calorie intake. Thus, a systematic review and meta-analysis of randomized clinical trials was performed to investigate the effects of LCDs compared with low-fat diets (LFDs), with and without caloric restriction, on inflammatory markers in adults. PubMed, Scopus, and Web of Science were searched through March 2022 to select intervention studies addressing LCDs vs. LFDs, in which the following circulating inflammatory markers were used: C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and interleukin (IL-6). Analyses were conducted comparing LCDs vs. LFDs through weighted mean differences (WMD) or standardized mean differences (SMD) and 95% confidence intervals (95% CIs) using random effects models. The systematic review and meta-analysis included a total of 51 studies with a total sample of 4,164 adults, with or without other chronic diseases. Intervention durations ranged from 2-144 weeks. LCDs, compared with LFDs, significantly decreased body weight [WMD = -1.35%, p = 0.001], CRP [SMD = -0.1, p = 0.03], and IL-6 [SMD = -0.15, p = 0.09]. However, LCDs did not significantly decrease TNF-α [SMD = -0.02, p = 0.7] compared to LFDs. In conclusion, LCDs have a beneficial effect on markers of inflammation by decreasing CRP and IL-6; this effect has an association with weight loss. However, LCDs were not more effective than LFDs in decreasing TNF-α.
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  • 文章类型: Systematic Review
    背景:尽管进行了大量研究,研究了低血糖指数(LGI)饮食对癫痫患者发作频率的影响,调查结果尚无定论。因此,我们进行了系统评价和荟萃分析,以阐明低血糖指数(LGI)饮食对儿童癫痫发作频率的潜在影响.
    方法:在2023年10月之前,在四个电子数据库中进行了全面的系统搜索,实现了根据PRISMA清单编写的系统综述和荟萃分析,没有时间或语言限制。采用随机效应模型来组合数据。使用体重平均差异(WMD)和95%置信区间(95%CI)分析主要结果。总的来说,13项研究符合合格标准并被纳入。
    结果:本研究中包含的出版物发表于2005年至2021年之间。本分析中包括的研究中干预的持续时间为6至58周。我们的研究结果表明,合并有效率<50%,≥50%,>90%癫痫患者接受低血糖指数饮食的癫痫发作减少为39%(95%CI:26,52),34%(95%CI:23,45),和19%(95%CI:13,25),分别。似乎在较短的干预期内,这种生酮饮食在减少癫痫发作方面的功效要大于12周。
    结论:本系统综述和荟萃分析提示,低血糖指数饮食可作为治疗小儿癫痫的有益手段。
    BACKGROUND: Despite extensive research examining the effect of a low glycemic index (LGI) diet on the frequency of seizures in patients with epilepsy, the findings are inconclusive. Hence, we performed a systematic review and meta-analysis in order to clarify the potential effect of a low glycemic index (LGI) diet on the frequency of seizures in children.
    METHODS: A systematic review and meta-analysis written in accordance with the PRISMA checklist was realized using a comprehensive systematic search in four electronic databases until October 2023 without time or language restrictions. A random effects model was employed to combine the data. The main outcomes were analyzed using weight mean difference (WMD) and 95 % confidence interval (95 % CI). In total, 13 studies met the eligible criteria and were included.
    RESULTS: The publications included in this study were published between 2005 and 2021. The duration of the interventions in the studies included in this analysis ranged from 6 to 58 weeks. Our findings indicated that the pooled efficacy rate for < 50 %, ≥ 50 %, > 90 % seizure reduction in patients with epilepsy receiving a low glycemic index diet was 39 % (95 % CI: 26, 52), 34 % (95 % CI: 23, 45), and 19 % (95 % CI: 13, 25), respectively. It seems that the efficacy of this ketogenic diet in reducing seizures is greater during a shorter intervention period than 12 weeks.
    CONCLUSIONS: This systematic review and meta-analysis suggests that the low glycemia index diet can be beneficial as a treatment for epilepsy in pediatric patients.
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  • 文章类型: Journal Article
    癫痫通常与其他神经系统疾病一起发生,比如自闭症,情感障碍,和认知障碍。研究表明,许多神经系统疾病具有共同的能量代谢障碍的病理生理学,神经炎症,氧化应激,和肠道生态失调。在过去的十年中,人们对使用代谢疗法治疗这些有或没有癫痫的疾病越来越感兴趣。一百多年前,高脂肪,低碳水化合物生酮饮食(KD)用于治疗癫痫.对于那些不能忍受KD的人来说,已经开发了其他饮食来提供类似的癫痫发作控制,大概是通过类似的机制。这些包括,但不限于,中链甘油三酯饮食,低血糖指数饮食,和卡路里限制。此外,膳食补充酮体,多不饱和脂肪酸,或三庚酸甘油酯也可能是有益的。这些饮食和补充剂减少神经元兴奋过度的拟议机制涉及异常能量代谢的正常化,抑制炎症,促进内源性抗氧化剂,和减少肠道菌群失调。这增加了这些饮食和代谢疗法可能不仅发挥抗癫痫作用的可能性,而且还可以减少癫痫患者的合并症。这里,我们探讨了这种可能性,并回顾了现有的临床和临床前证据.
    Epilepsy often occurs with other neurological disorders, such as autism, affective disorders, and cognitive impairment. Research indicates that many neurological disorders share a common pathophysiology of dysfunctional energy metabolism, neuroinflammation, oxidative stress, and gut dysbiosis. The past decade has witnessed a growing interest in the use of metabolic therapies for these disorders with or without the context of epilepsy. Over one hundred years ago, the high-fat, low-carbohydrate ketogenic diet (KD) was formulated as a treatment for epilepsy. For those who cannot tolerate the KD, other diets have been developed to provide similar seizure control, presumably through similar mechanisms. These include, but are not limited to, the medium-chain triglyceride diet, low glycemic index diet, and calorie restriction. In addition, dietary supplementation with ketone bodies, polyunsaturated fatty acids, or triheptanoin may also be beneficial. The proposed mechanisms through which these diets and supplements work to reduce neuronal hyperexcitability involve normalization of aberrant energy metabolism, dampening of inflammation, promotion of endogenous antioxidants, and reduction of gut dysbiosis. This raises the possibility that these dietary and metabolic therapies may not only exert anti-seizure effects, but also reduce comorbid disorders in people with epilepsy. Here, we explore this possibility and review the clinical and preclinical evidence where available.
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  • 文章类型: Journal Article
    虽然“精准营养”运动处于发展的早期阶段,几项调查比较了低脂肪与碳水化合物(CHO)改良饮食(即,低或还原CHO,低血糖指数/负荷饮食,和高纤维)在葡萄糖代谢正常与受损的人群中。这项范围审查的目的是总结支持以下假设的证据:CHO改良饮食对葡萄糖代谢受损人群的体重减轻更有效。这篇综述包括15篇文章:7项随机临床试验的回顾性分析和8项前瞻性随机临床试验与饮食相关的预设假设(低脂肪与CHO修饰的)×表型(正常与受损)互动。在7项回顾性研究中的6项和8项前瞻性研究中的3项发现了支持该假设的证据,这导致建议将CHO改良饮食作为葡萄糖代谢受损人群的一线选择。然而,支持这一建议的证据相对薄弱,和饮食处方应考虑可能影响总体饮食依从性的其他背景信息。需要使用创新的随机实验方法进行额外和严格的研究,以根据预处理血糖状态提出更强有力的饮食减肥建议。
    While the \"precision nutrition\" movement is at an early stage of development, several investigations have compared low-fat versus carbohydrate (CHO)-modified diets (i.e., low-or-reduced-CHO, low glycemic index/load diets, and high-fiber) in people with normal versus impaired glucose metabolism. The purpose of this scoping review was to summarize evidence in support of the hypothesis that CHO-modified diets are more effective for weight loss among people with impaired glucose metabolism. Fifteen articles were included in this review: seven retrospective analyses of randomized clinical trials and eight prospective randomized clinical trials with prespecified hypotheses related to a diet (low-fat vs. CHO-modified) × phenotype (normal vs. impaired) interaction. Evidence in support of the hypothesis was identified in six of seven retrospective and three of eight prospective studies, which led to a recommendation of CHO-modified diets as a first-line option for people with impaired glucose metabolism. However, the evidence in support of this recommendation is relatively weak, and dietary prescriptions should consider additional contextual information that may influence overall dietary adherence. Additional and rigorous research using innovative randomized experimental approaches is needed for stronger dietary weight loss recommendations based on pretreatment glycemic status.
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  • 文章类型: Meta-Analysis
    背景:国际指南推荐饮食干预作为胃食管反流病(GERD)患者最重要的治疗方法之一。缺乏证实这些治疗方式的有效性的证据。本研究旨在评估饮食干预对GERD患者干预研究中评估的GERD相关结局的疗效。
    方法:根据PRISMA进行系统评价和荟萃分析。PubMed/MEDLINE,WebofSciences,和Scopus数据库用于文献检索。两名独立研究人员搜索了直到2023年6月出版的相关出版物。纳入评估GERD患者饮食干预效果的干预研究。
    结果:在最初的文献检索中,共发现577篇文章。审查后,21项研究包括16种不同类型的饮食干预措施。干预措施分为低碳水化合物饮食(3项研究),高脂肪饮食(2项研究),进食速度研究(3项研究),低FODMAP饮食(2项研究),和其他干预措施(12项研究)。可以对低碳水化合物饮食和饮食干预速度进行荟萃分析。低碳水化合物饮食导致食管酸暴露时间显着减少(平均差异=-2.834%,95%置信区间(CI):-4.554至-1.114),与快速进食相比,缓慢的进食速度并未导致较低的反流事件百分比(风险比=1.044,95%CI:0.543-2.004).大多数其他干预措施仅在一项研究中显示出积极效果。
    结论:低碳水化合物饮食在GERD相关结局方面有显著改善,而缓慢的进食速度并没有导致反流事件的减少。关于GERD饮食干预的总体证据仍然很少。高品质,对于GERD患者,仍需进行长期随机对照试验以确认饮食干预的效果.
    BACKGROUND: International guidelines recommend dietary interventions as one of the most important treatments for patients with gastroesophageal reflux disease (GERD). Evidence to confirm the efficacy of these treatment modalities is lacking. The present study aims to evaluate the efficacy of dietary interventions on GERD-related outcomes evaluated in intervention studies on GERD patients.
    METHODS: A systematic review and meta-analysis was performed according to PRISMA. The PubMed/MEDLINE, Web of Sciences, and Scopus databases were utilized for the literature search. Two independent researchers searched for relevant publications published up until June 2023. Intervention studies evaluating the efficacy of dietary interventions in patients with GERD were included.
    RESULTS: A total of 577 articles were identified during the initial literature search. After reviewing, 21 studies with 16 different types of dietary interventions were included in the analysis. The interventions were divided into low-carbohydrate diets (3 studies), high-fat diets (2 studies), speed of eating studies (3 studies), low-FODMAP diets (2 studies), and other interventions (12 studies). A meta-analysis could be performed for low-carbohydrate diets and speed of eating interventions. Low-carbohydrate diets resulted in a significant reduction in esophageal acid exposure time (mean difference = -2.834%, 95% confidence interval (CI): -4.554 to -1.114), while a slow speed of eating did not lead to a lower percentage of reflux events compared to fast eating (risk ratio = 1.044, 95% CI: 0.543-2.004). Most other interventions showed positive effects in only a single study.
    CONCLUSIONS: Low-carbohydrate diets showed a significant improvement in GERD-related outcomes, while a slow eating speed did not result in a reduction in reflux events. The overall evidence regarding dietary interventions in GERD remains scarce. High-quality, long-term RCTs are still required to confirm the effects of dietary interventions in GERD patients.
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