Article(id=1320438571987751076, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, articleNumber=null, orderNo=null, doi=10.11847/zgggws1148011, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1748275200000, receivedDateStr=2025-05-27, revisedDate=1755792000000, revisedDateStr=2025-08-22, acceptedDate=1761840000000, acceptedDateStr=2025-10-31, onlineDate=1792746688124, onlineDateStr=2026-10-23, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746688124, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746688124, creator=13701087609, updateTime=1792746688124, updator=13701087609, issue=Issue{id=1320438244077056901, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='6', pageStart='641', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746609943, creator='13701087609', updateTime=1792748036545, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444227734065468, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444227734065469, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=743, endPage=748, ext={EN=ArticleExt(id=1320438572168106149, articleId=1320438571987751076, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Research progress in effects of the Jiangnan dietary pattern on cardiovascular health: a review, columnId=1320427713148597230, journalTitle=Chinese Journal of Public Health, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

Cardiovascular diseases encompass a group of disorders affecting the heart and vascular system, primarily including coronary artery disease, hypertension, stroke, heart failure, and arrhythmias. Cardiovascular diseases have emerged as one of the leading global health burdens. China experiences high prevalence, elevated mortality, and a rapidly increasing trend of cardiovascular diseases. Dietary patterns, recognized as a critical modifiable factor influencing the onset and progression of cardiovascular diseases, have garnered widespread attention. Evidence indicates that healthy dietary patterns can reduce the risk of cardiovascular diseases, whereas unhealthy dietary habits may elevate the disease incidence. The Jiangnan dietary pattern, a paradigm of traditional Chinese culinary culture, is characterized by mild flavors, refined preparation, and nutritional balance, emphasizing fresh ingredients, balanced meat-vegetable ratios, and healthy cooking methods. Studies suggest that this dietary pattern may modulate lipid profiles and inflammatory markers, thereby influencing the progression of cardiovascular diseases. This paper introduces the current status of cardiovascular diseases in China, discusses the relationship between such diseases and the Jiangnan dietary pattern, and analyzes the intervention effects and mechanisms of this dietary pattern.

, authors=Qizheng HUANG1, Xing WANG1, Fangbiao TAO1, 2, authorsList=Qizheng HUANG, Xing WANG, Fangbiao TAO, authorCompany=null, correspAuthors=Fangbiao TAO, authorNote=null, correspAuthorsNote=
TAO Fangbiao, E-mail:
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心血管疾病是一类涉及心脏和血管系统的疾病统称,主要包括冠心病、高血压、中风、心力衰竭、心律失常等,并已经成为全球主要健康负担之一。我国心血管疾病呈现出高发病率、高死亡率和快速上升的趋势。膳食模式作为影响心血管疾病发生和发展的关键因素,受到广泛关注。研究表明,健康的膳食模式可以降低心血管疾病的风险,而不良的膳食模式则可能提高心血管疾病的发生率。江南膳食模式是中国传统饮食文化的典范之一,以清淡、精致、营养均衡为特点,注重食材新鲜、荤素搭配和健康烹饪。江南膳食模式可通过调节血脂和炎症水平影响心血管疾病的发展进程。本研究旨在探讨中国心血管疾病的现状及其与江南膳食模式的关系,并分析膳食干预效果及其潜在机制。

, authors=黄启政1, 汪兴1, 陶芳标1, 2, *, *, authorsList=黄启政, 汪兴, 陶芳标, authorCompany=null, correspAuthors=陶芳标, authorNote=

黄启政(2001—),硕士在读,研究方向:生命早期暴露与心血管代谢健康

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陶芳标,E-mail:
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江南膳食模式对心血管疾病健康影响的研究进展
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黄启政 1 , 汪兴 1 , 陶芳标 1, 2, *, *
中国公共卫生 | 综 述 2026,42(6): 743-748
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中国公共卫生 |综 述 2026 , 42 (6) : 743 -748
江南膳食模式对心血管疾病健康影响的研究进展
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黄启政(2001—),硕士在读,研究方向:生命早期暴露与心血管代谢健康

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黄启政1, 汪兴1, 陶芳标1, 2, *, *
作者信息
  • 1安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥 230032
  • 2出生人口健康教育部重点实验室 安徽省环境与人口健康重点实验室,合肥 230032
通讯作者:
陶芳标,E-mail:
作者简介:

黄启政(2001—),硕士在读,研究方向:生命早期暴露与心血管代谢健康

Research progress in effects of the Jiangnan dietary pattern on cardiovascular health: a review
Qizheng HUANG1, Xing WANG1, Fangbiao TAO1, 2
Affiliations
  • 1Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
  • 2MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, China
  • Corresponding Author:
    TAO Fangbiao, E-mail:
出版时间: 2026-06-10 doi: 10.11847/zgggws1148011
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心血管疾病是一类涉及心脏和血管系统的疾病统称,主要包括冠心病、高血压、中风、心力衰竭、心律失常等,并已经成为全球主要健康负担之一。我国心血管疾病呈现出高发病率、高死亡率和快速上升的趋势。膳食模式作为影响心血管疾病发生和发展的关键因素,受到广泛关注。研究表明,健康的膳食模式可以降低心血管疾病的风险,而不良的膳食模式则可能提高心血管疾病的发生率。江南膳食模式是中国传统饮食文化的典范之一,以清淡、精致、营养均衡为特点,注重食材新鲜、荤素搭配和健康烹饪。江南膳食模式可通过调节血脂和炎症水平影响心血管疾病的发展进程。本研究旨在探讨中国心血管疾病的现状及其与江南膳食模式的关系,并分析膳食干预效果及其潜在机制。

江南膳食模式  /  心血管疾病  /  潜在机制  /  肠道生态  /  健康影响

Cardiovascular diseases encompass a group of disorders affecting the heart and vascular system, primarily including coronary artery disease, hypertension, stroke, heart failure, and arrhythmias. Cardiovascular diseases have emerged as one of the leading global health burdens. China experiences high prevalence, elevated mortality, and a rapidly increasing trend of cardiovascular diseases. Dietary patterns, recognized as a critical modifiable factor influencing the onset and progression of cardiovascular diseases, have garnered widespread attention. Evidence indicates that healthy dietary patterns can reduce the risk of cardiovascular diseases, whereas unhealthy dietary habits may elevate the disease incidence. The Jiangnan dietary pattern, a paradigm of traditional Chinese culinary culture, is characterized by mild flavors, refined preparation, and nutritional balance, emphasizing fresh ingredients, balanced meat-vegetable ratios, and healthy cooking methods. Studies suggest that this dietary pattern may modulate lipid profiles and inflammatory markers, thereby influencing the progression of cardiovascular diseases. This paper introduces the current status of cardiovascular diseases in China, discusses the relationship between such diseases and the Jiangnan dietary pattern, and analyzes the intervention effects and mechanisms of this dietary pattern.

Jiangnan dietary pattern  /  cardiovascular  /  potential mechanism  /  gut ecosystem  /  health effect
黄启政, 汪兴, 陶芳标. 江南膳食模式对心血管疾病健康影响的研究进展. 中国公共卫生, 2026 , 42 (6) : 743 -748 . DOI: 10.11847/zgggws1148011
Qizheng HUANG, Xing WANG, Fangbiao TAO. Research progress in effects of the Jiangnan dietary pattern on cardiovascular health: a review[J]. Chinese Journal of Public Health, 2026 , 42 (6) : 743 -748 . DOI: 10.11847/zgggws1148011
心血管疾病(cardiovascular disease, CVD)是全球死亡和疾病负担的主要原因,而我国的CVD患病率和发病率持续上升,其所带来的社会经济负担日渐加重,已成为重大的公共卫生问题[1]。世界卫生组织(World Health Organization, WHO)估计到2030年,每年将有近2 360万人死于CVD,心脏病和中风造成的死亡人数更多[2]。CVD由血性病变引起,无明显的临床症状,其特征是隐匿性、进行性和全身性对身体造成损害,其发病率和死亡率已超过癌症[3]。在众多影响心血管健康的因素中,膳食模式起到重要作用。现有研究表明,健康的膳食模式可以降低CVD的风险,而不良的膳食模式则可能提高CVD的发生率[4]。江南膳食模式是中国江南地区(包括江苏、浙江、上海等地)的传统饮食文化,其以清淡、精致、营养均衡而闻名,强调低盐、高钾和丰富的膳食纤维摄入。本研究旨在通过文献综述探讨江南膳食模式对中国居民CVD的影响,并分析其潜在机制,为CVD的预防提供科学依据,并为公众提供合理的饮食建议。
江南饮食模式蕴含健康智慧,具有显著的CVD预防等健康效果。其特点包括增加玉米、燕麦等粗粮摄入,以调节血脂;选用富含多不饱和脂肪的菜籽油,降低多种疾病风险;多食用白肉、减少红肉,改善心血管健康;控制钠盐摄入,避免高血压等疾病;同时保证丰富多样的蔬菜和水果摄入,协同降低慢性病风险。
江南饮食模式的地域范围主要涵盖长江中下游南岸的环太湖流域,包括今天的浙江北部、江苏南部和上海全境。历史上,江南水乡稻作农业发达,但精米加工技术普及前,糙米等未精制谷物曾是主食的重要组成部分。尽管现代饮食趋向精细化,江南地区仍保留燕麦粥、玉米杂粮粥等传统吃法,既体现“粗细搭配”的养生智慧,也可通过增强饱腹感从而调节血脂,对CVD预防产生积极影响。江南地区营养干预研究显示,江南模式食用谷类中的玉米、燕麦、紫米等粗粮,可显著降低血清总胆固醇(total cholesterol, TC)(β= −8.59%,P=0.013)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)(β= −12.97%,P=0.004)和非高密度脂蛋白胆固醇(non-high-density lipoprotein cholesterol, non-HDL-C)(β= −10.98%,P=0.040)水平[5]。相较于江南地区食用粗粮和未精制谷物,加工食品与精制食品的摄入是西方饮食的主要特征。加工食品指脱离天然状态、通常为延长保质期或改善口感而经过改造的食品,典型代表包括快餐、包装零食和含糖饮料。精制食品则是指在加工过程中去除天然纤维和营养成分的食品,例如白面粉、精白米及添加糖类[6]。美国一项研究表明,采用西方饮食模式(以大量摄入加工食品和精制食品为特征)的群体,相较于遵循健康饮食模式的人群,罹患心脏病、糖尿病和中风的风险显著更高[7]。OliveiraE C E D等[8]通过腹部肥胖评估为高心血管风险的45名受试者的实验性研究中发现补充燕麦麸可有效降低甘油三酯(triglyceride, TG)、TC和HDL-C水平。动物模型研究也表明,燕麦在调节肠道微生物群及其后续减少肥胖方面具有显著效果,对于食用西方饮食的小鼠,燕麦麸和黑麦麸均能通过改变肠道微生物群的组成,改善肝脏炎症和葡萄糖反应受损的情况[9]。同时有研究显示,与摄入精制谷物产品的健康成年人相比,摄入全谷物玉米与全谷物小麦和大米产品(每日提供约14 g纤维/2 000千卡)可显著降低其体内的LDL-C(P=0.035)和non-HDL-C水平(P=0.047)[10]。袁心雨等[11]对重庆市19 862名成年居民开展的横断面研究显示,减少精制谷物及腌制食品的摄入量,同时增加全谷物、新鲜蔬果的摄入比例,有助于形成更为健康的平衡膳食模式,从而显著降低CVD的发病风险。
江南地区作为油菜籽主产区,菜籽油供应充足且成本适中,长期融入本地饮食传统,其风味清淡的特点也与江南饮食追求鲜嫩爽口的偏好相契合。菜籽油具有很高的多不饱和/饱和脂肪比例(富含Omega-6),在降低总死亡率方面具有与单不饱和油相似的保护作用,能有效降低肥胖、高血压、脑卒中、冠心病和多种癌症的风险,对健康长寿更有益处[12]。Corboy J等[13]通过测量LDL在体外对铜催化氧化的敏感性,研究在全麦饮食中用低芥酸菜籽油替代膳食脂肪的效果。结果显示,18名受试者在食用菜籽油/麦片饮食4周后,与基线正常饮食相比,体外LDL氧化敏感性降低(r=0.976,P<0.001)。在一项随机、双盲、对照、交叉研究中,59名健康的正常脂肪血症男性食用优化或标准菜籽油(20 g/d)和人造黄油(22 g/d)3周。结果显示,优化菜籽油与传统食用油相比,显著降低了反式脂肪酸浓度(P=0.009)[14]。Baxheinrich A等[15]对81例代谢综合征患者进行了为期6个月的饮食干预,结果显示,菜籽油组和橄榄油组患者的体重分别下降7.8和6.0 kg。同时其2组患者的体质量指数降低(−2.7,−2.1 )、腰围减少(−9.9,−8.9 cm)、体脂减少(−2.9%,−2.0%)和瘦体重增加(+3.0%,+2.1%)(P<0.05)。CVD风险状况也有了明显改善。与低α–亚麻酸含量的橄榄油饮食相比,高α–亚麻酸摄入量使得血清TG水平和舒张压呈现更显著的降低,这表明α–亚麻酸可能具有独立的有益代谢作用。
传统江南地区(长江中下游平原)河网纵横、湖泊密布,是著名的“水乡泽国”。这种地理环境极其不利于大规模牧草生长和放牧业(红肉来源)的发展。相反,丰富的水域为渔业和水稻种植提供了得天独厚的条件。因此,鱼类、虾蟹、贝类等水产品以及禽类(鸭、鹅等水禽)成为最易获得、最新鲜、最经济的优质动物蛋白来源。美国和欧洲大型前瞻性队列研究表明,长期摄入大量红肉,尤其是加工肉类,与男性和女性的总死亡率、CVD、结直肠癌和2型糖尿病的风险增加相关[16]。在29 682名美国成年人中,经过中位数为19年、最长可达30年的随访研究发现,加工肉类、未加工红肉或家禽(而非鱼类)的较高摄入量与CVD风险显著增加相关[17]。西方饮食的特点还在于饱和脂肪和反式脂肪的高摄入量。饱和脂肪主要存在于肉类、黄油和奶酪等动物性食品中,而反式脂肪则常见于烘焙食品和油炸食品等加工食品中。大量摄入饱和脂肪和反式脂肪已被证实与心血管疾病风险升高存在关联[18]。与美欧等国多使用红肉和饱和脂肪相比,“饭稻羹鱼”是江南地区膳食结构的主体。作为水网密布的地区,江南盛产淡水鱼类、虾蟹等水产,为当地居民提供了丰富优质的白肉来源,白肉脂肪总含量相对较低,不饱和脂肪酸含量较高,特别是富含n–3多不饱和脂肪酸的鱼类,对预防高脂血症和心脑血管疾病等有重要作用[19]。一项在严重高甘油三酯血症患者中开展的有关调脂药物的双盲、随机、对照研究的试验结果表明,含有二十碳五烯酸(eicosapentaenoic acid, EPA)和二十二碳六烯酸(docosahexaenoic acid, DHA)游离脂肪酸形式的新型制剂,在每日2、3和4 g的所有测试剂量下,均能显著降低TG和non-HDL-C浓度[20]。Omega-3脂肪酸能够增加高密度脂蛋白胆固醇水平,同时降低TC和TG水平,从而降低CVD的风险[21]。意大利心肌梗死生存研究组招募了11 324例近期心肌梗死患者,采用随机对照设计,将受试者分为4组:n-3多不饱和脂肪酸组(1 g/d,n=2 836)、维生素E组(300 mg/d,n=2 830)、联合干预组(同时补充上述两种制剂,n=2 830)以及空白对照组(不补充任何制剂,n=2 828),经过3.5年的随访,结果显示,接受n–3种多不饱和脂肪酸组的主要死亡终点、非致死性心肌梗死和非致死性中风的主要终点相对于空白对照组减少了15%(P<0.02)。此外,全因死亡率和猝死率分别降低20%和45%[22]。前瞻性队列研究的荟萃分析发现,白肉摄入量最高的组别与摄入量最低的组别相比,受试者的全因死亡率显著降低6%。当按地理区域(即美洲、亚洲、欧洲)对分析进行分层时,全因死亡和CVD死亡方面的研究结果一致,这在一定程度上解释了不同的基础饮食以及一些未被测量的与生活方式相关的因素,包括食物烹饪方法对全因死亡率的影响[23]。
江南饮食多采用清蒸、白灼、快炒、煮汤等低温、少油的烹饪方法,极大限度地保留食材的原汁原味和营养成分。调味偏好清淡,善用食材本身的鲜味(如用香菇、笋、海鲜提鲜),而非依赖过多的盐、酱油和辛辣调料,减少了过量的钠盐摄入。盐是一种由阳离子和阴离子组成的离子化合物,食用盐按重量计含40%的钠和60%的氯。历史上,盐被用作防腐剂,因为细菌无法在高盐浓度的环境中繁殖。人体细胞每天大约需要0.5 g的钠来维持生命功能[24]。然而,尽管钠是必不可少的营养素,过量摄入却会带来一系列健康问题。现代饮食中,加工食品和快餐的普及使得人们往往在不知不觉中摄入了过量的钠盐。这种从必需到过量的过渡,不仅打破了体内的钠平衡,还可能引发高血压、CVD、肾脏损伤等多种健康风险。Mills KT等[25]研究了来自慢性肾功能不全队列研究的慢性肾病患者,24 h尿钠排泄量(3次采集的平均值)与临床心血管事件之间的关联。研究发现,钠排泄量最高四分位组的心血管事件累积发生率高于最低四分位组,数据表明钠排泄量与心血管事件之间存在显著的线性关联。平均钠摄入量每增加1 g/d,平均收缩压就会增加2.86 mm Hg(1 mm Hg=0.133 3 kPa)[26]。WHO建议通过有效且安全的策略降低人群平均钠摄入量,以减少高血压及其相关疾病负担。将低钠盐替代品纳入人群策略中,已逐渐被认为是一种可能的减钠策略,尤其是在整体钠摄入量中大部分来自烹饪或餐桌上添加的盐的人群中。低钠盐替代品通过用钾或其他矿物质替代部分钠,降低钠的浓度[27]。将钠摄入量控制在3 000~5 000 mg/d范围内可能是最小化心血管事件和死亡风险的“最佳”范围。
我国江南地区年降雨量大、气候温热湿润,四季温差较小、生长期长,常年可以种植蔬菜[28],因此当地饮食中蔬菜和水果的种类繁多且供应充足。江南膳食中蔬菜种类丰富,包括绿叶蔬菜(如菠菜、青菜)、根茎类(如萝卜、茭白)、瓜果类(如冬瓜、黄瓜)以及豆类(如毛豆、蚕豆)等。水果和蔬菜含有多种营养物质和植物化学物质,包括纤维、维生素C、类胡萝卜素、抗氧化剂、钾、类黄酮和其他未识别的化合物,这些化合物可以降低患慢性病和过早死亡的风险。一项前瞻性研究显示,膳食摄入和/或血液中维生素C、类胡萝卜素(总类胡萝卜素、β–胡萝卜素、α–胡萝卜素、β–隐黄质和番茄红素)以及α–生育酚的浓度(作为蔬菜和水果摄入的指标)与冠心病(coronary heart disease, CHD)、中风、CVD和全因死亡率的风险降低相关[29]。蔬菜和水果也是钾的来源,土豆、西红柿、香蕉和橙子等食物中钾含量较高,增加钾的摄入量(特别是较高的钾钠比)与较低的血压相关[30]。一项前瞻性队列研究结果表明,豌豆和玉米等淀粉类蔬菜通常通过罐装加工,这可能导致抗氧化活性显著下降。除了在生产过程中高血糖负荷值和营养素含量降低外,果汁作为液体,可能会导致餐后血糖和胰岛素的快速显著升高,而不会显著增强食欲[31]。需要注意的是,某些类型的果汁,如柑橘汁,可能比其他果汁具有更高的抗氧化活性和降低致动脉粥样硬化脂质的作用[32]。
江南膳食干预研究的结果表明,采用传统江南饮食模式(以水果、水产、时令蔬菜、菜籽油和粗粮为主)能显著改善心血管代谢健康指标。多项前瞻性研究分别纳入果蔬联合摄入、水果单独摄入及蔬菜单独摄入与CVD的关联分析。结果显示,果蔬联合摄入总RR值为0.92(95%CI=0.90~0.95,I2=31%),水果单独摄入的RR值为0.87(95%CI=0.82~0.92,I2=79%),蔬菜单独摄入的RR值为0.90(95%CI=0.87~0.93,I2=12%)。水果、蔬菜以及水果和蔬菜的联合摄入量每增加200 g/d,CHD的相对风险降低8%~16%,中风的相对风险降低13%~18%,CVD的相对风险降低8%~13%,总癌症的相对风险降低3%~4%,全因死亡率的相对风险降低10%~15%[33–35]。在特定水果来源中,柑橘类水果、柑橘类果汁、绿叶蔬菜和富含维生素 C 的水果和蔬菜与CVD风险呈负相关[36]。苹果摄入量每增加1个标准差(53 g/d),全因死亡率风险比降至0.89(95%CI=0.81~0.97);与每日摄入量低于5 g的参照组相比,摄入5~100 g/d组风险比为0.80(95%CI =0.65~0.98),每日摄入超过100 g(约1个苹果)组的风险比显著降低至0.65(95%CI =0.48~0.89)[37]。在蔬菜类别中,最值得注意的是,每日一份绿叶蔬菜的摄入量与CVD、CHD和中风发病率以及CHD死亡率的风险降低12%~18%相关[38]。剂量—反应分析进一步表明,果汁、十字花科蔬菜及绿叶蔬菜/沙拉的摄入量与死亡风险呈显著降低相关,而罐装水果摄入量则与死亡风险呈增加相关[39–41]。合理的饮食成分、正确的饮食习惯和方法以及适当的营养比例是确保人类健康的基础,而不合理的饮食模式是高血压、糖尿病和骨质疏松症等多种慢性疾病的罪魁祸首[42]。因此,应加强对人群各因素的干预,包括膳食、生活方式及血糖、血压管理等,促进心血管整体的改善[43]。
低水平炎症和氧化应激是CVD发生发展的核心机制。炎症反应通过内毒素介导的细胞因子释放促进内皮损伤和动脉粥样硬化,而氧化应激则通过体内活性氧(reactive oxygen species, ROS)积累导致代谢紊乱和血管功能障碍。此外,肠道菌群失调可通过破坏肠屏障完整性和物质代谢异常,进一步加剧心血管病理进程。
低水平炎症是许多慢性疾病的诱因,这种类型的炎症随着年龄的增长而增加,在高龄人群中很常见,并且是CVD的已知危险因素[44]。血浆内毒素在这一过程中扮演关键角色,可促进白细胞介素(interleukin,IL)-1β、IL-6、IL-10和C–反应蛋白(C-reactive protein, CRP)等促炎性细胞因子的释放。IL-1β由免疫细胞、受损内皮细胞及心肌细胞释放,可进一步加剧心脏炎症反应。江南膳食每天摄入新鲜蔬菜、每天摄入全谷物和每周吃豆类和豆类食品可降低居民的全因死亡风险[45]。蔬菜中的多酚类(如槲皮素)、类胡萝卜素(如β–胡萝卜素)和维生素C等可通过抑制核因子κB通路,减少IL-1β的生成。IL-6是心血管炎症领域研究最深入的白细胞介素之一,在急性缺血应激后的心肌组织损伤和加剧炎症反应中起关键作用。此外,慢性炎症导致老年患者IL-6、CRP和其他细胞因子的表达增加,是导致死亡的主要原因之一[46]。IL-10可以减轻免疫细胞向结肠的浸润,并降低体内巨噬细胞炎性基因的表达[47]。IL-1β、IL-6、IL-10和CRP等炎性细胞因子和细菌内毒素的释放会进一步损伤患者内皮细胞,导致CVD患者处于长期且愈加严重的炎症反应中,减弱心脏功能,也会促进脂质积累,从而导致动脉粥样硬化和CVD的发生[48]。膳食干预可通过调节脂质代谢与炎症信号通路改善这一病理过程,江南膳食的食用油类主要为菜籽油,菜籽油中富含不饱和脂肪酸,如亚油酸和亚麻酸,能够改善代谢适应性,增强内质网–线粒体接触的形成,进而促进线粒体能量代谢以及细胞毒性T淋巴细胞的效应功能[49]。同时,也显著抑制了高脂饮食诱导的促凋亡因子c-Jun N末端激酶蛋白磷酸化,并降低其靶蛋白Bax的表达,通过调节内质网应激(ERs)和JNK/Bax通路,减少血管内皮细胞和平滑肌细胞的异常凋亡,维持血管完整性[50]。亚油酸能够以芳香烃受体依赖的方式降低Th17/Treg细胞比率,同时通过Stat1在Ser727位点的磷酸化促进Treg细胞分化,从而发挥抗炎的作用[51]。
氧化应激引起的代谢紊乱是指ROS和抗氧化防御系统失衡,导致细胞成分(如脂质、蛋白质、DNA)氧化损伤,进而干扰正常代谢过程的现象。ROS在细胞内多种生化反应中生成,涉及内质网、线粒体和过氧化物酶体等细胞器,同时也是氧正常代谢的天然副产物。重金属、烟草烟雾、药物、外源性物质、污染物和辐射等多种因素均可诱导ROS的产生[52]。ROS过量产生的氧化应激是导致心血管和代谢疾病(如高血压和动脉粥样硬化)发病机制的最重要因素之一。ROS的过度积累会损害物质,同时限制氧化应激,通过各种细胞机制保护心血管和代谢功能[53]。ROS的过度积累可通过氧化损伤生物大分子(如脂质、蛋白质及DNA),进而促进心血管代谢疾病的发生。然而,机体通过膳食摄入外源性抗氧化剂可有效调控氧化应激水平。江南膳食模式以丰富的植物性食物为特征,尤其是水果和蔬菜的摄入量较高。这些食物不仅提供了人体必需的维生素和矿物质,更含有多种具有生物活性的植物化学物质,可以清除ROS,防止大分子受到氧化损伤;调节参与新陈代谢、细胞增殖、炎症反应和抗氧化防御的基因的表达和活性[54]。
肠道菌群紊乱导致肠道屏障完整性受损,增加肠道炎症,并进一步增强宿主循环吸收的微生物产物和代谢物,促进CVD的进展[55]。肠道菌群紊乱导致物质代谢异常,例如脂质、葡萄糖和色氨酸代谢异常可能会导致CVD[56]。最近的研究表明,肠道微生物群落和微生物群衍生代谢物的改变可能在CVD的发生和发展中发挥作用。宿主–微生物群相互作用调节身体的炎症和代谢途径,它们的改变可能有助于与心血管系统密切相关的多种免疫介导和代谢疾病的发病机制[57]。江南膳食模式添加了粗粮、坚果和豆制品等富含膳食纤维的食物,通过摄入未精制的全食物(如全谷物、豆类、蔬菜和水果)来改善胃肠道健康。对肠道具有良好的调节作用(例如,消化与吸收、通过时间、粪便形成),对微生物(肠道微生物群组成和发酵代谢物的变化)也具有很好的调节作用[58]。相反,高脂饮食诱发的肠道菌群失调刺激小肠中促炎细胞因子的分泌,增加小肠上皮的通透性使更多微生物及其代谢产物进入循环,导致肥胖、胰岛素抵抗和葡萄糖耐量异常[59]。
本研究探讨了江南膳食模式对中国居民CVD的影响,并深入分析了江南膳食模式对LDL-C和TG的影响作用,进而影响心血管健康。江南膳食模式通过其富含全谷物、蔬菜水果、水产品及菜籽油的饮食结构,以及低盐、低红肉的饮食特点,能够显著改善血脂谱(降低LDL-C、TG水平)、调节血压、减轻氧化应激和炎症反应,并通过调节肠道菌群平衡等多重机制,对心血管健康产生显著保护作用。通过调节免疫系统,抑制过度的炎症反应,减轻全身的炎症状态,保护心血管系统免受炎症损伤。由于不同人群的基因背景、代谢状态、饮食习惯、生活方式存在差异,这种差异使得在大规模研究中实施个性化饮食方案面临诸多挑战。未来需要在不同国家、地区的人群中进行进一步的纵向研究,以更好地了解江南膳食模式对不同人群心血管健康的影响。

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doi: 10.11847/zgggws1148011
  • 接收时间:2025-05-27
  • 首发时间:2026-10-23
  • 出版时间:2026-06-10
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  • 收稿日期:2025-05-27
  • 修回日期:2025-08-22
  • 录用日期:2025-10-31
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    1安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,合肥 230032
    2出生人口健康教育部重点实验室 安徽省环境与人口健康重点实验室,合肥 230032

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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