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Kohlenhydrate und Blutdruck - Nicolai Worm - 09.05.2007
Die angekündigte Metaanalyse ist heute erschienen. Ergebnis: Ein isokalorischer Austausch von Kohlenhydraten gegen einfach ungesättigte Fettsäuren bewirkt eine gerinfügige Blutdrucksenkung. Allerdings weisen die Autoren im Text darauf hin, dass die Studienlage eigentlich noch zu dürftig ist und auf Grund methodischer Mängel die Aussagekraft beschränkt ist.
Shah M, Adams-Huet B, and Garg A. Effect of high-carbohydrate
or high-cis-monounsaturated fat diets on blood pressure: a meta-analysis
of intervention trials. Am J Clin Nutr 2007;85:1251–6.
Background: The Dietary Approaches to Stop Hypertension (DASH)
diet is recommended to manage blood pressure. The DASH diet is low in
saturated fat, but it is not clear whether saturated fat should be
preferentially replaced with carbohydrate or unsaturated fat, especially
cis-monounsaturated fat.
Objective:Ameta-analysis of intervention studies comparing high
carbohydrate and high-cis-monounsaturated fat diets was conducted
to increase understanding of the effect of carbohydrate and cis-mono-
unsaturated fat on blood pressure.
Design: For study diets to be included in the analysis, they had to be
isoenergetic, and the subjects’ body weight had to remain stable. Ten
studies (6 randomized crossover, 1 randomized parallel, and 3 non-
randomized) met the inclusion criteria.
Results: According to the random-effects model, which incorporates
between-study variation to estimate the overall effect, diets rich
in carbohydrate resulted in significantly higher systolic blood pressure
[x difference: 2.6 (95% CI: 0.4, 4.7) mm Hg; p<0.02] and diastolic
blood pressure [1.8 (0.01, 3.6) mm Hg; p<0.05] than did
diets rich in cis-monounsaturated fat. When the meta-analysis was
limited to randomized crossover studies, both systolic [1.3 ( 0.3,
2.9) mm Hg; p<0.11] and diastolic [0.9 ( 0.2, 2.1) mm Hg; p<0.11]
blood pressure were higher with a high-carbohydrate than with
a high cis-monounsaturated fat diet, but the differences were not
significant.
Conclusions: Diets rich in carbohydrate may be associated with
slightly higher blood pressure than diets rich in cis-monounsaturated
fat. However, the magnitude of the difference may not justify making
recommendations to alter the carbohydrate and cismonounsaturated
fat content of the diet to manage blood pressure.