背景:在心血管和代谢领域,营养产品和功能食品的使用在几个国家正在上升。指南的制定和实施对于将研究衍生知识和循证医学转化为临床实践至关重要。基于这些考虑,本文的目的是探讨有关心脏代谢疾病的最新国际指南(血脂异常,肥胖,2型糖尿病(T2DM)和心血管疾病(CVD)的预防。一些,但不是全部,血脂异常的指南提到营养产品是治疗轻度血脂异常的潜在有用选择,但也表明与它们对硬终点的影响相关的证据水平低(心肌梗塞,中风,CVD相关死亡)。在最近的肥胖指南中,有人提到,在这种情况下,没有安全有效的膳食补充剂或营养产品可用于减肥管理,在这一领域需要更多高质量的研究。所审查的T2DM指南没有提到对这种疾病的任何具体的营养方法。也不是温和的形式,如胰岛素抵抗和糖尿病前期。
结论:心脏代谢疾病管理的主要国际指南对营养产品的关注仍然有限。由于强有力的科学证据是有用和有效的指南的背景,在心脏代谢疾病的营养产品领域,迫切需要实施高质量的临床研究。
BACKGROUND: The use of nutraceutical products and functional foods in the cardiovascular and metabolic field is rising in several countries. Preparation and implementation of
guidelines are pivotal for translating research-derived knowledge and evidence-based medicine to the clinical practice. Based on these considerations, the aim of this paper is to explore if and how nutraceutical products are discussed by the most recent international guidelines related to cardio-metabolic diseases (dyslipidaemia, obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) prevention). Some, but not all,
guidelines for dyslipidaemia mention nutraceutical products as potential useful options for the treatment of mild dyslipidaemia, but also indicate the low level of evidence associated to their effects on hard endpoints (myocardial infarction, stroke, CVD-related death). In the most recent
guidelines on obesity, it is mentioned that no safe and effective dietary supplement nor nutraceutical product is available for the management of weight loss in this condition, and more high-quality studies are necessary in this field. The examined
guidelines for T2DM do not mention any specific nutraceutical approach to this disease, nor to milder forms, such as insulin resistance and pre-diabetes.
CONCLUSIONS: The focus on nutraceutical products in the main international
guidelines for cardio-metabolic disease management remains limited. Since robust scientific evidence is the background of useful and effective guidelines, the implementation of high-quality clinical research is strongly needed in the field of nutraceutical products for cardio-metabolic diseases.