每天食用 4 到 6 份全谷物食品，可以同时改善与心脏病相关的多个主要风险因素。图片来源：Shutterstock
Eating four to six servings of whole grains each day may improve several major risk factors for cardiovascular disease, according to new research published September 15 in the European Heart Journal.
根据 9 月 15 日发表在《欧洲心脏杂志》上的最新研究，每天食用 4 到 6 份全谷物食品，可能有助于改善导致心血管疾病的几个主要风险因素。
The findings come from a systematic review and meta-analysis that combined evidence from 87 clinical trials examining how whole grain consumption affects cardiovascular risk factors.
这些研究结果来自一项系统的回顾性和荟萃分析。该分析整合了 87 项临床试验的数据，这些试验旨在探讨全谷物的摄入对心血管风险因素的影响。
Across the studies, diets higher in whole grains were associated with improvements in body weight, blood pressure, cholesterol, and blood glucose. Together, these changes could help lower the long term risk of heart disease.
在各项研究中，富含全谷物的饮食有助于改善体重、血压、胆固醇和血糖水平。这些改善共同有助于降低患心脏病的长期风险。
How Much Whole Grain Is Enough?
需要多少全谷物才算足够呢？
The research was led by Dr. Helda Tutunchi from Tabriz University of Medical Sciences, Iran. She said: “Although higher whole-grain intake has long been linked to better heart health in population studies, clinical trials have produced mixed findings. This left an important practical question unanswered: how much whole grain should people eat to meaningfully improve cardiovascular health? To address this, we systematically combined and analyzed all available randomized controlled trials to identify the amount of whole grain associated with the greatest benefits.”
这项研究由伊朗大不里士医科大学的赫尔达·图图恩奇博士领导。她表示：“虽然多项流行病学研究都表明，摄入更多全谷物有助于改善心脏健康，但临床试验的结果则不尽相同。这就引出了一个重要的实际问题：人们需要摄入多少全谷物才能真正改善心血管健康呢？为了解决这个问题，我们系统地整理并分析了所有现有的随机对照试验，以确定能带来最大益处的全谷物摄入量。”
The analysis included more than 6,500 participants from trials conducted across Asia, Europe, the United States, Canada, Australia, and Brazil. People who consumed more whole grains tended to have lower body weight, smaller waist circumference, and reduced blood pressure.
这项分析涵盖了来自亚洲、欧洲、美国、加拿大、澳大利亚和巴西的 6,500 多名参与者。那些摄入更多全谷物的人，通常体重更轻、腰围更小，血压也更低。
Higher whole grain intake was also associated with lower levels of total cholesterol and low-density lipoprotein cholesterol (LDL or ‘bad’ cholesterol), as well as lower triglycerides, glucose, and interleukin-6 (a sign of inflammation) in the blood.
摄入更多全谷物还能降低血液中的总胆固醇和低密度脂蛋白胆固醇（即“坏胆固醇”）水平。同时，全谷物的摄入还有助于降低血液中的甘油三酯、葡萄糖以及白细胞介素-6 的水平——后者是炎症的标志物。
Benefits were already apparent among people consuming 30 to 40 grams of whole grains per day (dry weight). However, the strongest effects were generally observed at 60 to 100 grams per day.
那些每天摄入 30 到 40 克全谷物的人，已经能明显感受到其带来的益处。不过，当摄入量达到 60 到 100 克时，效果最为显著。
That amount is equivalent to about four to six servings of whole grains daily. In practical terms, that could include a bowl of oatmeal, a sandwich made with whole grain bread, and a serving of brown rice.
这个数量相当于每天摄入 4 到 6 份全谷物食品。具体来说，可以包括一碗燕麦粥、一个用全谷物面包做的三明治，以及一份糙米。
Benefits Across Several Heart Risk Factors
对多种心脏风险因素都有益处
Dr. Tutunchi said: “This is the largest and most comprehensive meta-analysis of randomized controlled trials on wholegrain intake and cardiovascular risk factors. Unlike previous reviews, we looked specifically at how much wholegrain people need to eat to get the greatest benefits. We also evaluated the certainty of the evidence and found high-certainty evidence for improvements in several outcomes, including body weight, waist circumference, and total cholesterol.
图图恩奇博士说：“这是迄今为止关于全谷物摄入与心血管风险因素之间关系的最全面、最系统的随机对照试验分析。与以往的研究不同，我们专门研究了人们需要摄入多少全谷物才能获得最大的健康益处。我们还评估了各项证据的可靠性，结果发现，有充分的证据表明，全谷物的摄入有助于改善体重、腰围和总胆固醇等指标。”
“However, most of the trials we included were relatively short, with an average duration of about eight weeks. As a result, we cannot determine whether these benefits are maintained over the long term. In addition, relatively few studies evaluated very high wholegrain intakes, above 140 grams per day, so the effects at those intake levels remain uncertain.
不过，我们纳入的研究大多持续时间较短，平均约为八周。因此，我们无法确定这些益处是否能在长期内持续存在。此外，很少有研究评估过每天超过 140 克的高剂量全谷物摄入量，所以在这种摄入水平下的效果仍不确定。
“Our findings provide a practical indication of the amount of wholegrain that may be needed to achieve meaningful improvements in cardiovascular risk factors. Increasing wholegrain intake is a relatively simple, accessible and affordable dietary strategy that can complement other lifestyle and medical interventions.
“我们的研究结果为了解需要摄入多少全谷物才能有效改善心血管风险因素提供了实际参考。增加全谷物的摄入量是一种相对简单、容易实施且成本较低的饮食策略，可以与其他生活方式改善措施及医疗干预措施相辅相成。”
“We found that most benefits occur at intakes of approximately 60 to 100 grams per day, toward the upper end of current dietary recommendations. These findings do not necessarily call for major changes to existing guidelines, but they support public health strategies that help people increase their whole-grain intake and move toward the higher end of current targets.
“我们发现，当全谷物的摄入量达到每天约 60 到 100 克时，就能带来最大的健康益处。这一数值处于当前饮食建议的上限范围内。这些研究结果并不一定意味着需要大幅修改现有的指导方针，但它们有助于推动公共卫生措施的实施，从而帮助人们增加全谷物的摄入量，使其更接近当前的建议标准。”
“One important finding is that whole grains may benefit cardiovascular health through several modest improvements acting together, rather than through one large effect on a single risk factor. We observed improvements across multiple pathways, including blood lipids, blood pressure, glucose regulation, body fat and some markers of inflammation. Although the change in each individual risk factor was generally modest, improving several risk factors simultaneously could contribute to a greater reduction in long-term cardiovascular risk. However, the included trials did not assess cardiovascular events directly, so longer-term studies are needed to confirm this.”
“一项重要的研究发现是：全谷物通过多种细微的改善作用共同促进心血管健康，而非对某个单一风险因素产生显著影响。我们在多个方面观察到了积极效果，包括血脂、血压、血糖调节、体脂以及一些炎症指标。虽然每个单独风险因素的改善幅度都不大，但同时改善多个风险因素有助于更显著地降低长期心血管风险。不过，这些研究并未直接评估心血管事件，因此需要进一步的研究来证实这一结论。”
The researchers caution that the clinical trials mainly measured cardiovascular risk factors rather than actual heart attacks, strokes, or other cardiovascular events. Most of the trials were also relatively brief, so additional long term studies will be needed to determine whether the observed improvements persist and ultimately translate into fewer cases of cardiovascular disease.
研究人员指出，这些临床试验主要衡量的是心血管风险因素，而非实际的心脏病发作、中风或其他心血管事件。此外，大多数试验的持续时间都较短。因此，需要进一步的长期研究来确认这些改善效果是否能够持续下去，从而真正减少心血管疾病的发病率。
What Makes Whole Grains Different?
全谷物与普通谷物的区别何在？
In an accompanying editorial, Dr. Cecilie Kyrø from the Danish Cancer Institute, Copenhagen, and colleagues said: “More than half a century ago, Sir Denis Burkitt and colleagues proposed that the refining of staple carbohydrates, with the accompanying removal of cereal fiber (i.e. from whole to refined grains), underpinned a broad spectrum of ‘Western’ diseases via effects on stool bulk, transit time, and the colonic milieu. Whole grains refer to cereal grains where the three main parts — bran, germ, and endosperm — are all retained in the same proportions as in the intact kernel, whether consumed as whole kernels, flakes, or milled into flour and used in bread and other foods.
在一篇随附的社论中，来自哥本哈根丹麦癌症研究所的塞西莉·基罗博士及其同事指出：“半个多世纪前，丹尼斯·伯基特爵士及其同事提出，主食中碳水化合物的精制过程，以及随之而来的谷物纤维的去除——也就是从全谷物到精制谷物的转变——是通过影响粪便的体积、通过肠道的时间以及结肠内的环境，从而引发各种‘西方疾病’的根源。所谓全谷物，指的是那些保留了谷物中三个主要组成部分的谷物：麸皮、胚芽和胚乳。无论这些全谷物是以完整颗粒的形式食用，还是被磨成面粉后用于制作面包和其他食品，其营养成分都保持不变。”
“A meta-analysis of trials investigating the effect of whole grains on cardiometabolic risk markers by Naghshi et al. is published in this issue of the European Heart Journal and includes 87 trials of 6529 study participants in total. The meta-analysis shows high-certainty evidence for reductions in body weight, waist circumference, total cholesterol. and interleukin-6 (IL-6), and moderate-certainty evidence for improvements in LDL cholesterol, triglycerides, systolic blood pressure, fasting plasma glucose, and insulin resistance (HOMA-IR).
Naghshi 等人对各项研究全谷物对心血管代谢风险指标影响的分析结果发表在本期的《欧洲心脏杂志》上。该分析涵盖了 87 项研究，共有 6529 名参与者参与其中。分析结果显示，全谷物有助于减轻体重、降低腰围、总胆固醇和白细胞介素-6 的水平；同时，全谷物还能改善低密度脂蛋白胆固醇、甘油三酯、收缩压、空腹血糖以及胰岛素抵抗指标。这些效果属于“高度可信”的证据。
“Importantly, the meta-analysis includes dose-response analyses, addressing differences in whole-grain intake between trials and providing quantitative evidence to inform food-based dietary guidelines. Overall, intakes of 60-100 g/day dry weight (∼4-6 servings) were found to be clearly related to relevant cardiometabolic improvements.
重要的是，这项荟萃分析还包含了剂量-反应分析，从而揭示了各项研究之间在全谷物摄入量方面的差异。这些分析为制定基于食物的饮食指南提供了有力的定量依据。总体而言，每天摄入 60-100 克全谷物干重（相当于 4-6 份全谷物食品）与心脏代谢功能的改善有明显的相关性。
“For clinicians, the message from Naghshi et al. is reassuringly simple: encouraging patients to replace refined grain foods with minimally processed whole grains is likely to yield modest but meaningful improvements in body weight, waist circumference, and blood lipids, perhaps particularly in individuals with type 2 diabetes. At the population level, even small shifts in these markers can translate into substantial reductions in cardiometabolic events. Adding evidence from research into other disease endpoints indicates that the beneficial effects of whole-grain foods even go substantially beyond cardiometabolic disease.
对于临床医生来说，Naghshi 等人的研究结果相当简单明了：鼓励患者用经过最少加工的全谷物来替代精制谷物食品，有望带来体重、腰围和血脂水平的适度但显著的改善。这一效果在 2 型糖尿病患者身上可能更为明显。从整体来看，即使这些指标只有微小的改善，也能有效降低心血管代谢疾病的风险。其他研究也表明，全谷物食品的益处远远不止于心血管代谢疾病领域。
“The dose-response analyses by Naghshi et al. suggest that intakes of around 60-100 g/day whole grains (∼4-6 servings) are needed to achieve measurable cardiometabolic benefits. Current US dietary guidelines recommend 2-4 servings of whole grains per day within an overall pattern that emphasizes ‘real food’ and reduced intake of ultra-processed products. While this is an important step in the right direction, the trial evidence indicates that higher whole-grain intakes than presently recommended in some guidelines may be optimal for cardiometabolic health.
Naghshi 等人的剂量-反应分析表明，要想获得明显的心脏代谢健康益处，每天需要摄入大约 60-100 克的全谷物（相当于 4-6 份的量）。美国目前的饮食指南建议，每天应摄入 2-4 份全谷物，同时强调应多吃“天然食物”，减少超加工食品的摄入。虽然这是朝着正确方向迈出的重要一步，但研究结果表明，为了维护心脏代谢健康，或许需要比现有指南所建议的更高剂量的全谷物摄入量。
“From a policy perspective, the challenge is to make minimally processed whole-grain staples accessible, affordable, and culturally acceptable, while avoiding a drift towards ultra-processed products that merely add whole grains to otherwise highly processed formulations.”
从政策层面来看，面临的挑战在于如何让那些经过最少加工的全谷物主食变得易于获取、价格合理且符合文化习惯。同时，还需要避免人们转向那些虽然添加了全谷物，但实际上属于高度加工食品的产品。
Taken together, the findings suggest that whole grains may support cardiovascular health not through one dramatic effect, but through several smaller improvements occurring at the same time. Replacing refined grains with minimally processed whole grain foods could therefore offer a relatively simple way to improve cholesterol, blood pressure, blood sugar regulation, body composition, and inflammation.
综合来看，这些研究结果表明，全谷物之所以有助于心血管健康，并非因为某种单一的显著效果，而是因为它们能同时带来多种细微的积极影响。因此，用经过最少加工的全谷物食品来替代精制谷物，是一种相对简单的改善胆固醇水平、血压、血糖调节能力、身体成分以及减少炎症的方法。
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