针对植物生物活性物质如黄烷-3-醇的指南建议偏离了先前的建议,因为它不是基于缺陷,而是基于健康结果的改善。然而,越来越多的临床数据反映了摄入黄烷-3-醇的益处超过了潜在的危害.因此,专家小组的目标是制定黄烷-3-醇和心脏代谢结果的摄入建议,以告知包括临床医生在内的多个利益相关者,政策制定者,公共卫生实体,和消费者。指南的制定遵循了营养与饮食学会提出的过程,其中包括使用证据来决策框架。本指南的研究(157项随机对照试验和15项队列研究)以前在最近发表的系统综述和荟萃分析中进行了综述。审查了报告的质量和证据强度以及偏倚风险。在起草准则时,我们考虑了提供黄烷-3-醇安全性指导的权威科学机构的数据评估和意见.文献中支持了支持黄酮-3-醇摄入量在400-600mg/d范围内引起的心脏代谢保护的适度证据。Further,增加食用黄烷-3-醇有助于改善血压,胆固醇浓度,还有血糖.一些生物标志物的证据强度最强(即,收缩压,总胆固醇,HDL胆固醇,和胰岛素/葡萄糖动力学)。应该注意的是,这是一个基于食品的指南,而不是黄烷-3-醇补充剂的建议。该指南基于在一系列疾病生物标志物和终点中观察到的有益效果。尽管已经审查了对现有数据的全面评估,本文发现的证据缺口可以为科学家指导未来的随机临床试验提供信息.
Guideline recommendation for a plant bioactive such as flavan-3-ols is a departure from previous recommendations because it is not based on deficiencies but rather improvement in health outcomes. Nevertheless, there is a rapidly growing body of clinical data reflecting benefits of flavan-3-ol intake that outweigh potential harms. Thus, the objective of the Expert Panel was to develop an intake recommendation for flavan-3-ols and cardiometabolic outcomes to inform multiple stakeholders including clinicians, policymakers, public health entities, and consumers.
Guideline development followed the process set forth by the Academy of Nutrition and Dietetics, which includes use of the Evidence to Decision Framework. Studies informing this
guideline (157 randomized controlled trials and 15 cohort studies) were previously reviewed in a recently published systematic review and meta-analysis. Quality and strength-of-evidence along with risk-of-bias in reporting was reviewed. In drafting the
guideline, data assessments and opinions by authoritative scientific bodies providing guidance on the safety of flavan-3-ols were considered. Moderate evidence supporting cardiometabolic protection resulting from flavan-3-ol intake in the range of 400-600 mg/d was supported in the literature. Further, increasing consumption of dietary flavan-3-ols can help improve blood pressure, cholesterol concentrations, and blood sugar. Strength of evidence was strongest for some biomarkers (i.e., systolic blood pressure, total cholesterol, HDL cholesterol, and insulin/glucose dynamics). It should be noted that this is a food-based guideline and not a recommendation for flavan-3-ol supplements. This
guideline was based on beneficial effects observed across a range of disease biomarkers and endpoints. Although a comprehensive assessment of available data has been reviewed, evidence gaps identified herein can inform scientists in guiding future randomized clinical trials.