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大脑慢慢变傻 幕后“黑手”或是反式脂肪酸

  近日,日本研究人员在美国神经病学学会《神经病学》杂志发表了一项新研究,发现摄入富含反式脂肪酸的工业食品会增加阿尔兹海默症等痴呆症的患病风险。

年少饮食习惯不良,年老痴呆风险增大

  脂肪酸是最简单的一种脂,根据分子结构的不同,可分为饱和脂肪酸、不饱和脂肪酸。其中,不饱和脂肪酸若含有反式非共轭双键结构,则被称为反式脂肪酸。

  痴呆症是个“大家族”,除了最为人熟知的阿尔兹海默症外,还包括血管性痴呆症、全因性痴呆症及混合性痴呆症等。从2002年开始,日本研究人员对1628名60岁及以上无痴呆的日本社区居民,开展了一项长达10年的跟踪研究,研究者测定参与者血清中反式脂肪酸的水平,并使用模型评估人群全因性痴呆症、阿尔兹海默症和血管性痴呆症的风险比例。

  研究人员发现,在这三类痴呆症中,人体血清中反式脂肪酸的水平与全因性痴呆症、阿尔兹海默症有关联,但与血管性痴呆症的患病风险并无显著关联。

  在随访过程中,共有377名参与者患上了特定类型的痴呆症,其中包括247名阿尔兹海默症患者和102名血管性痴呆症患者。当研究人员调整了传统的痴呆症风险因素后,机体较高的血清反式脂肪酸水平与人群全因性痴呆症风险和阿尔兹海默症风险增加明显相关,当调整了饮食因素,如总热量的摄入及饱和、不饱和脂肪酸的摄入等,这些关联性依然很显著。

  研究人员得出结论,血清中较高的反式脂肪酸水平,可能是全因性痴呆症和阿尔兹海默症发生的危险因素。

  事实上,反式脂肪酸与痴呆症的关联早就被科研人员关注了。科技日报记者了解到,早在20世纪90年代,就有研究人员发现,那些在青少年时期具有不良饮食习惯的人,到老年时患老年痴呆症的比例增大。此前还有研究人员对居住在美国芝加哥近郊的2560名65岁以上居民进行长期跟踪研究后发现:在老年人群中那些大量摄取反式脂肪酸的人,认知功能减退更快。

那么,此次新研究又有哪些亮点呢?

  “痴呆症的危险因素有很多。以阿尔兹海默症为例,现在已知的致病危险因素包括遗传、环境因素两大类。环境因素又包括吸烟、肥胖、糖尿病、体育运动缺失、老年抑郁等等。这些因素可能相互关联、作用。”北京市卫生健康委员会健康科普专家、首都医科大学北京安定医院老年科副主任医师李鹏表示,当研究某单一因素对病症的影响时,该病症的其他危险因素就成了“混杂”因素,会干扰研究结果。此次研究剔除了传统痴呆症风险的“混杂”因素,以类似控制变量的方法,进一步证实了反式脂肪酸的摄入与痴呆症的发生具有关联性。“这是该研究的创新点。”李鹏说。

进入血液参与代谢,是多种疾病的“帮凶”

反式脂肪酸为何会让大脑慢慢变傻?

  “这一机制目前还没有彻底搞清楚,但学界对于反式脂肪酸致阿尔兹海默症的机理提出了多种假说。如反式脂肪酸可增加脑内Aβ蛋白沉积、引发脑神经细胞氧化损伤等。”李鹏表示。

  老年斑是阿尔兹海默症的主要神经病理特征,而Aβ蛋白是老年斑的主要组成成分。有研究显示,反式脂肪酸会增加Aβ蛋白含量,升高总胆固醇量,加快大脑的动脉硬化。还有研究表明,反式脂肪酸可以抑制细胞增殖,通过降低特定酶的活性,造成神经细胞氧化损伤。而细胞的氧化损伤往往与衰老、功能退化有关。

  除了痴呆症,反式脂肪酸还是很多类疾病的“帮凶”。中日友好医院胃肠外科副主任医师孟凡强博士在接受科技日报记者采访时说:“以往的研究表明,反式脂肪酸摄入过多可能会增加心脑血管疾病、糖尿病、肥胖等患病风险。”

  据世界卫生组织官网显示,反式脂肪酸会增加低密度胆固醇的水平,同时会降低高密度胆固醇水平。高密度胆固醇可在动脉中清理胆固醇并将其运至肝脏,然后分泌到胆汁中;而低密度胆固醇则是学界公认的心血管疾病风险的生物标志物之一。如果摄入富含反式脂肪酸的食品,患心脏病风险将增加21%,死亡率风险增加28%。另外,有证据表明反式脂肪酸可加剧炎症和内皮功能障碍。

  “反式脂肪酸会进入血液,参与人体代谢。因此,与血液、代谢相关的疾病都应该警惕反式脂肪酸可能存在的不良影响。”孟凡强指出,反式脂肪酸的多量存在会增加人体血液的黏稠度,增加血栓形成可能;由于反式脂肪酸易于在机体沉积,从而导致腹型肥胖等,而肥胖又可以引发多种疾病。

  李鹏告诉记者,孕期或哺乳期的女性过多摄入反式脂肪酸,会通过胎盘或乳汁传递给胎儿,影响胎儿和婴儿的生长发育。青少年如摄入过多,也会对中枢神经系统发育造成不良影响。

没有任何健康效益,主要源于加工食品

  “反式脂肪酸没有任何已知的健康效益。”世界卫生组织官网显示。

  既然反式脂肪酸“罪状”多、危害大,人们在日常生活中如何避免过多摄入?

  首先要搞清楚的问题是反式脂肪酸的来源。“某些天然食品中也含有反式脂肪酸,但其主要来源于加工食品。”孟凡强表示,天然存在的反式脂肪酸来自牛羊等反刍动物。反刍动物摄入饲料后,在胃内发生生化反应产生反式脂肪酸,吸收后进入动物体内。因此牛羊肉、牛奶、乳制品的脂肪中会含有少量的反式脂肪酸。

  有研究提示,加工食品中的反式脂肪酸产生于给油脂加氢,使液态变为固态形成“部分氢化”油的生产过程。氢化植物油是反式脂肪酸主要的来源。与普通油脂相比,氢化油脂更稳定,不易变质,且在室温下能保持固态形状,可以让加工食品变得更“有型”,运输和储存更加便利。此外,氢化油脂还能够增加食品的口感和美味,牢牢抓住消费者的胃。而所有含有“氢化油”或者使用“氢化油”油炸过的食品都会含有反式脂肪酸,如人造黄油、人造奶油及相关制品,使用“氢化油”烘焙、油炸的食品等。

  据统计,全球每年约有54万例死亡与摄入工业生产的反式脂肪酸有关。2010年全球反式脂肪平均摄入量占总能量摄入的1.4%,各国之间从0.2%到6.5%不等,在每天2000卡路里饮食中占0.13―4.3克。根据现有少量信息,北美、拉美和北非/中东地区的摄入量最高,而且年轻人的摄入量一般而言更高。

  以每天摄入2000卡路里总能量计算,世界卫生组织建议将每天反式脂肪酸摄入量限制在2.2克以内。根据我国食品安全相关要求,食品包装上应标注反式脂肪酸的含量,民众购买时可做参考。

  “民众在日常生活中应尽可能少摄入反式脂肪酸,保持健康的饮食方式和习惯很重要。”孟凡强表示,希望未来反式脂肪酸所带来的危害会得到很好的预防和控制。

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