维生素用于预防成人慢性疾病:临床应用
Robert H Fletcher1, Kathleen M Fairfield
1Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, 133 Brookline Ave, Sixth Floor, Boston, MA 02215, USA. Robert_Fletcher@hms.harvard.edu
JAMA
|June 19, 2002
概括
维生素摄入量低于最佳水平是常见的,也是慢性疾病的危险因素,特别是在老年人中. 成年人可能会从维生素补充剂中受益,但个性化的建议和测试是有限的.
科学领域:
- 营养科学 营养科学
- 公共卫生 公共卫生
- 预防医学 预防医学
背景情况:
- 经典的维生素缺乏疾病在西方社会是罕见的.
- 维生素摄入量低于最佳水平很普遍,特别是在老年人中,并且与慢性疾病风险有关.
- 饮食本身往往无法提供所有必需维生素的最佳水平.
研究的目的:
- 审查超出缺乏症综合征的低最佳维生素摄入量对健康的影响.
- 讨论维生素补充剂在缓解慢性疾病风险方面的作用.
- 为成年人提供维生素补充实践指南.
主要方法:
- 文献综述和综合有关维生素状况和慢性疾病的证据.
- 分析特定维生素 (叶酸,B6,B12,D,A,E,C) 在健康和疾病中的作用.
- 对个性化维生素补充策略的现有证据的评估.
主要成果:
- 叶酸,维生素B6,B12,D和抗氧化维生素 (A,E,C) 的不足最佳摄入量与心血管疾病,神经管缺陷,癌症,骨质疏松症和其他慢性疾病的风险增加有关.
- 大多数成年人无法通过饮食单独获得最佳的维生素摄入量.
- 根据个体特征量身定制多种维生素或使用维生素水平测试来指导补充剂的证据有限.
结论:
- 鉴于维生素摄入量低于最佳水平的流行及其与慢性疾病的关联,在随机试验中获得更强有力的证据之前,对成年人进行常规维生素补充是明智的.
- 医生应建议患者使用维生素,促进必要的补充剂 (例如,育龄妇女的叶酸),并阻止潜在的有害做法 (例如,怀孕期间高剂量维生素A).
- 需要进一步的研究,以建立基于证据的指导方针,以个性化维生素补充和有针对性的测试.
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