素食對心血管疾病危險因子的影響

The Effect of Vegetarian Diet on Cardiovascular Risk Factors

心血管疾病為全球第一大死亡原因，也是每年台灣衛福部十大死因統計的前三位，依據美國心臟病協會發佈的心血管疾病預防指南指出，80%的心血管疾病是可以被預防的，而健康飲食即為準則之一。素食以大量植物性食物為主要來源，被普遍認為是一種健康的飲食型態，許多的研究顯示，素食飲食對改善CVD危險因子有所助益，例如血脂、血糖、血壓與肥胖等問題，近期也有越來越多的證據指出，素食與腸道微菌叢(gut microbiota)及發炎反應的關聯，例如，發炎標誌物C-反應蛋白(CRP)與腸道微菌叢中氧化三甲胺(TMAO)的濃度。然而，此種飲食模式仍有其潛在風險，例如營養素的缺乏導致較高的同半胱胺酸(Hcy)數值，近年研究更指出，素食者較低的低密度膽固醇(LDL-C)可能反而提高中風的風險。透過素食飲食對CVD影響的了解，利用文獻回顧的方式，將有助於提供大眾及相關專業人員未來疾病治療的參考。

Cardiovascular disease (CVD) is the leading global cause of mortality and makes up the top-three causes of death each year in Taiwan according to Taiwan’s Ministry of Health and Welfare. More than 80 percent of all cardiovascular events can be prevented through lifestyle changes, and adopting a heart healthy eating plan according to Primary Prevention of Cardiovascular Disease Guidelines published by the American Heart Association (AHA). Vegetarian dietary patterns typically emphasize the consumption of vegetables, fruits, grains, legumes, and nuts. These diets are generally considered to be a healthy. Many studies have shown that vegetarian diets help improve CVD risk factors, including elevations in blood lipids, blood sugar and blood pressure as well as obesity. There is also increasing evidence showing that vegetarian diets can affect gut microbiota and inflammation, both closely linked to CVD via their effects inflammation marker C-reactive protein (CRP) and gut microbiota- Trimethylamine oxide (TMAO). However, vegetarian diets come with some potential risks, including nutrient deficiency induces high levels of homocysteine (Hcy). It has also been suggested that although vegetarian diets can lower the heart disease risk, they may increase the risk stroke due to lower low-density cholesterol (LDL-C) level. It is important to understand the impact of vegetarian diet on CVD. We therefore performed a literature review of studies investigating this relationship. We hope the results of our review can serve as reference for the general public and clinicians including nutritionists concerned with effect of lifestyle choices on the heart health of their patients.