隨著生活方式的改變，超重、肥胖及其伴隨的代謝綜合征（如高血糖、高血壓、血脂異常、高尿酸等）已成為威脅我國居民健康的主要公共衛生問題。全民營養周提出“以食為藥，防治一體”的主題，正是提醒我們：科學的飲食，不僅是健康的基石，更是防治代謝性疾病的有力武器。

代謝綜合征：不止是“胖”那么簡單

數據顯示，我國超過一半的成年人超重或肥胖，而其中38.9%—62.4%的人合并代謝綜合征。代謝綜合征是指一個人同時存在腹型肥胖、高血壓、高血糖、高甘油三酯、低高密度脂蛋白中的至少三項問題。這些因素疊加，顯著增加心腦血管疾病、2型糖尿病等慢性病的風險。

好消息是，代謝綜合征是可以被“吃”好的。

以食為藥：營養干預的核心策略

1. 控制能量，減重為先

減重的核心是保持每日500—750千卡的能量差?！扼w重管理指導原則（2024版）》推薦限能量、高蛋白、低碳水的膳食模式，有助于減輕體重、改善血糖和血脂。

2. 高膳食纖維：代謝的“清道夫”

膳食纖維在控制血糖、降低血脂、緩解高尿酸方面發揮多重作用：

控糖：每日攝入25—36克膳食纖維（尤其是可溶性纖維），可顯著降低糖化血紅蛋白和空腹血糖。

降脂：可溶性纖維如燕麥β-葡聚糖、車前子，能有效降低總膽固醇和低密度脂蛋白。

降尿酸：纖維通過調節腸道菌群，產生短鏈脂肪酸，幫助緩解痛風炎癥、減少尿酸生成。

建議多吃全谷物、豆類、蔬菜和水果，保證每日纖維攝入量達到25—35克。

3. 礦物質與維生素：小元素，大作用

鎂、鋅、硒：改善胰島素抵抗，幫助控制血糖。

維生素B12、葉酸：改善2型糖尿病患者的血糖控制。

維生素C、E、D：有助于降低尿酸水平，改善血壓和脂代謝。

鉀、鈣：DASH飲食和CHH飲食的核心成分，能顯著降低血壓。

4. 健康脂肪與植物化合物

n-3脂肪酸（如魚油）：每日2克可降低甘油三酯25%—30%。

植物甾醇、大豆異黃酮、大蒜素：均有助于降低膽固醇。

姜黃素、多酚：具有抗炎、改善脂肪肝的潛力。

科學搭配：高營養密度是關鍵

在限能量的前提下，選擇高營養密度的天然食材，如綠葉蔬菜、豆制品、全谷物、堅果、魚類等，可以同時滿足多種營養素需求，避免單一營養素強化的局限。

中國人民解放軍總醫院第四醫學中心提出的一種新型營養餐食模式——限能量、高蛋白、高膳食纖維、低飽和脂肪、低鈉、富含維生素與礦物質，已在真實世界研究中顯示出良好的減重和代謝改善效果。

“以食為藥”并非一句口號，而是基于大量科學證據的醫學營養治療策略。面對代謝綜合征，我們不必等到生病才去醫院，從今天開始，調整飲食結構，選擇高營養密度的天然食物，就是在為自己“開處方”。

中國人民解放軍總醫院第四醫學中心正在開展《特定膳食計劃逆轉超重/肥胖合并血脂等異常的研究：一項前瞻性隨機對照臨床試驗》，本研究為國內首個以營養干預為主要手段對超重肥胖合并血脂異常患者進行逆轉的研究，預期會有不錯的研究結果。

全民營養周，讓我們一起行動：用食物守護健康，用營養防治一體。

（中國人民解放軍總醫院第四醫學中心營養科主任 劉玲英）

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