膳食脂肪與健康
——專欄主持：王以群 資深研究員/英國帝國理工學院

膳食脂肪是人類所需的三大宏量營養素之一，其對維持人體的健康有著十分重要的作用。近百年來，隨著經濟的發展與生活方式的轉變，脂肪攝入的過量和失衡進而促使多種慢性疾病發生的問題已在全世界范圍受到廣泛關注。聯合國糧農組織和世界衛生組織為此在1977年、1993年和2008年組織了全球有關專家共同商討，發表了多篇指導性報告[1-3]。本專欄主持榮幸邀請到參與三次專家研討會的英國Michael A CRAWFORD教授，和參與2008年會議的澳大利亞Andrew J. SINCLAIR教授與美國J. Thomas BRENNA 教授加入。在此值得一提的是，中國青島大學的李鐸教授代表中國也受邀參與了2008年的研討會。《糧油食品科技》邀請我來共同組織開展“膳食脂肪與健康”專欄就是促進加強中外專家對這方面的交流和討論，以達到提高認識、改進應用、增進健康之目的。

我曾經在中國國家油脂工程和科技的唯一專業研究所工作了二十多年，了解和見證了中國從上世紀50年代起建立了國家油脂生產和加工體系，從多出油、保民生，出好油、優質量，用好油、善其用，吃好油、促健康等各個發展時期。至今中國無論從油脂資源開發和生產，還是油脂加工和應用都在趕超發達國家，并且許多達到了世界先進水平。然而，隨著膳食脂肪包括動物食品中脂肪消費的迅速增加，近年來一些地區和人群的攝入量超過了一些發達國家和世界衛生組織、聯合國糧農組織所推薦的水平，并且把以前受國際好評的中國傳統低脂膳食模式[4]轉向西方高脂模式。Michael A CRAWFORD教授在上世紀70年代就提醒世人要警惕西方高脂和脂肪酸不平衡膳食會帶來的不健康和疾病。因此，在上世紀末我就從油脂科技研發轉向關注膳食脂肪與健康關系。在本世紀初就跟隨Michael A CRAWFORD教授在此方面的研究，他也非常推崇在上世紀70-80年代由陳君石院士主持的中國65個縣生態和生活方式的大型調查，其中中國膳食模式對比西方膳食模式顯現了許多明顯的優處，并且給予了世人對于膳食與健康認識的深刻思考。在2003年我遇見陳君石教授，我們談到了膳食脂肪對健康的重要性，他隨后就召集我們有關專家討論和主編了《膳食脂肪與健康》一書，于2008 年出版[5]。

Dietary fat is one of the three macronutrients required by human beings. It plays a very important role in maintaining human health. Over the past 100 years, along with the development of economy and transformation of lifestyle, excessive and unbalanced intake of dietary fat and various chronic diseases caused, is attracting widespread attention around the world. The Food and Agriculture Organization of United Nations (FAO) and the World Health Organization (WHO) organized the joint consultations with relevant experts around the world in 1977, 1993 and 2008,and published numbers of guiding reports[1-3]. I, as the chair of this special issue, is of great honour to invite professor Michael A CRAWFORD, director of the Institute of Brain Chemistry &Human Nutrition, UK, who has participated in all of the three consultations; and also with professors Andrew J. SINCLAIR from Deakin University and Monash University, Australia and J.Thomas BRENNA from University of Texas at Austin and Cornell University, USA, who both partook the joint expert consultation in 2008. It is worth mentioning here that professor Duo LI at Qingdao University was also invited to contribute to the 2008 consultation on behalf of China. The Journal of Science and Technology of Cereals, Oils and Foods invited me to co-organize this special issue of “Dietary Fat and Health” is to conduct and promote exchanges and discussions between Chinese and international experts in the area, as well as to raise awareness, improving application and health.

目前，人們已認識到膳食脂肪會關聯身體健康，許多人也進一步知道膳食脂肪酸要平衡才好。但是，如何全面認識和實踐仍然需要各方面深入和關聯的研究。例如，各大宏觀營養素間的作用和平衡、膳食脂肪和微量元素及其它成分的作用和平衡、膳食模式和遺傳、如何正常健康代謝、食品色香味與營養等等。2021年年底，陳君石院士又領銜推出《中國人群身體活動指南（2021）》[6]，這為身體活動促進健康代謝作出了科學的詮釋和指導。陳院士還在本專欄開始時做了指導和鼓勵。

本期特約專欄共組織了5篇文章。十分感謝作者們的大力支持。他們分別是：

專欄文章之一：中國疾病預防控制中心營養與健康所及國家衛生健康委微量元素與營養重點實驗室的張堅研究員和賈珊珊博士，以及國家糧食和物資儲備局科學研究院龐邵杰博士共同撰寫了《新時期國民膳食脂質攝入推薦的幾點建議》。他們對比歐盟和北美國家的狀況，對我國居民膳食結構改變、并且重點對膳食脂肪攝入和健康進行了全面回顧和討論。其中對我國18歲及以上居民的膳食脂肪供能比上限 (U-AMDR) 仍然維持在30%E，但是建議應考慮提高老年人膳食脂肪的U-AMDR。由于我國居民膳食中n-6/n-3PUFA比的平均值目前已經達到8.6，因此建議將膳食中n-6/n-3PUFA比值的推薦值納入新版膳食脂肪參考攝入量推薦中。對于我國城市居民和農村居民膳食膽固醇攝入量處于正常范圍，但是對于心腦血管疾病等慢性疾病的患者，建議在相應疾病指南中推薦膳食膽固醇攝入量。閱讀原文詳見本期P1-P6。

I had worked for more than 20 years in the National Research Institute for Oil and Fat Engineering and Research & Development in China. During this period, I had witnessed several monumental advancements in the national system of oil and fat production and processing since its establishment in the 1950s. It had evolved from mass extraction efficiently of edible oils, shifted to production of edible oils with high quality and safety, then to production of various special oils and eventually to promoting health with balanced dietary fat. China is catching up with developed countries in terms of oils and fats resource developments and production,processing and application. Many have reached world’s advanced levels. However, with the rapid increase in consumption of dietary oil and fat, including animal fats, some Chinese regions and populations in recent years have exceeded the levels recommended by several developed countries and the WHO/FAO. As a result,the previous internationally acclaimed Chinese traditional lowfats dietary pattern[4]has been transformed to the Western high-fats pattern. As far back as in 1970s, Professor Michael A CRAWFORD had reminded the world to be alerted to unhealthy lifestyle and diseases caused by Western high-fats and unbalanced fatty acids diets. With the awareness of fast developments on dietary fats and impact to health in China, at the end of the last century, I switched from oil and fat technology Research & Development to focus on relationships between dietary fat and health, then followed Professor Michael A CRAWFORD to study in this area at the beginning of this century. Professor CRAWFORD had also highly praised the large-scale survey on ecology and lifestyles in 65 Chinese counties, led by Professor Jun-shi CHEN (Academician of CAE)in the 1970s -1980s. Findings from the survey demonstrated Chinese dietary patterns had many obvious advantages compared with Western dietary patterns. This gave the world a sense of profound new perspective on the understanding of diet and health. In 2003, I met Professor Junshi CHEN, we talked about the importance of dietary fat to health, he then convened our experts to discuss and edited the book “Dietary Fat and Health”, which was later published in 2008 in China[5].

專欄文章之二：美國康奈爾大學和德克薩斯大學奧斯汀分校的J.Thomas BRENNA教授撰寫了《Omega-6支撐身體，Omega-3支撐大腦：均衡攝入對兒童大腦發育的影響》。BRENNA教授指出膳食脂肪中的必需脂肪酸是機體組織結構和功能的必要組成部分。他強調了Omega-6（O6）系列亞油酸（LA）對身體的重要性，譬如是皮膚組織的組成要素，并且是炎癥、血栓形成、免疫和其他信號分子的前體；關于Omega-3 （O3）系列 α -亞麻酸，特別是其長鏈代謝產物 ——二十二碳六烯酸（DHA），是大腦、視網膜和部分神經組織中的關鍵組分。因此必需脂肪酸的均衡膳食攝入至關重要，尤其是對人體健康及營養不良兒童的大腦發育尤為重要。然而目前食用油脂主要是來自植物資源，從植物籽中提取出的食用油脂富含LA6脂肪酸（缺乏O3脂肪酸）。隨之在代謝通路中，高濃度的LA脂肪酸可拮抗O3脂肪酸代謝，因而，在懷孕動物的飼料中，只提供富含LA6 但缺乏 O3脂肪酸的油脂，會導致幼崽大腦發育不良，這便需要人工干預以幫助其實現O3脂肪酸代謝。研究表明，低含量LA且含DHA的油脂可改善大腦的功能。世界衛生組織（WHO）非常重視大腦的營養健康，其食品法典委員會建議在用于治療嚴重急性營養不良兒童的即食治療食品中，使用含有均衡脂肪酸成分的脂肪。目前，業界已經有了調整油脂成分的方法，以保證膳食脂肪酸均衡，從而維持整個生命周期的大腦健康。中英雙語閱讀詳見本期P7-P22。

It is well known now that dietary fat is associated closely with health, and more people are aware of the importance of balanced intake. However to fully understand and the application of balanced intake of dietary fatty acids will require more in-depth and related research in areas such as role and balance of major macronutrients, dietary fat, trace elements and other components, dietary patterns and genetics, as well as metabolism and nutrition etc. At the end of 2021, professor Jun-shi CHEN led the launch of “Physical Activity Guidelines for Chinese (2021)”[6], which provided a scientific interpretation and guidance on using physical activity to promote healthy metabolism.Professor CHEN also gave guidance and encouragement to us at the beginning of this special issue.

A series of 5 articles were presented by generous contributions from the guest authors in this special issue. They are:

Professor Jian ZHANG, Dr. Shan-shan JIA from National Institute for Nutrition and Health, and Dr. Shao-jie PANG from Academy of National Food and Strategic Reserves Administration,China co-authored “Suggestions for Chinese Dietary Lipids Reference Intakes in the New Period”, in which they contrasted the situation in the European Union and North American countries, and conducted a comprehensive review and discussion on the changes in the dietary structure of Chinese residents, focusing on dietary fat intake and health today. They suggested that, the upper limit of dietary fat energy supply ratio (U-AMDR) for adult residents in China would be still maintained at 30%E, and a recommended the intake value of n-6/n-3 PUFA ratio by WHO/FAO should be included in the new version of the dietary fat guideline in China.The dietary cholesterol intake of Chinese residents in my country is in the normal range, but for patients with chronic diseases it is recommended to have dietary cholesterol intake limits in the corresponding disease guidelines. See the article in P1-P6.

專欄文章之三：澳大利亞莫納什大學和迪肯大學的Andrew J. SINCLAIR教授撰寫了《世界食物供應中亞油酸含量高對人體健康的影響》。對于當前植物油是攝入脂肪的主要來源，許多植物油富含亞油酸。因此，隨著食用油脂攝入的增長亞油酸的消耗量也顯著增長。SINCLAIR教授對亞油酸（LA）在人體健康中的利與弊做了深入地探討。他指出亞油酸之所以是必需脂肪酸，因其在人體皮膚中發揮著重要作用，并且是前列腺素和相關化合物的前體。與此同時，他重點探討了富含亞油酸的食物攝入對關節炎和頭痛、非酒精性脂肪肝和神經功能的影響，其原因是來自亞油酸和其他長鏈多不飽和脂肪酸的脂質介質。當前，世界糧食飲食結構造成膳食亞油酸與n-3多不飽和脂肪酸的不平衡，以及源自這些多不飽和脂肪酸的脂質介質的不平衡，他提醒大眾這種膳食脂肪酸不平衡極易導致亞健康狀態。中英雙語閱讀詳見本期P23-P40。

專欄文章之四：美國哈佛大學醫學院Jing X. KANG（康景軒）教授撰寫了《研發生產富含Omega-3脂肪酸食品是改善民眾營養健康狀況的重要飲食策略》評論文章。KANG 教授強調了必需脂肪酸的兩種系列Omega-6和Omega-3脂肪酸，它們都必須從食物中獲取，因為人體本身不能合成。這兩類脂肪酸對細胞結構和功能非常重要，并在代謝和功能上有所不同，其拮抗調節許多生理和病理過程。因此，Omega-6和Omega-3脂肪酸之間的相對平衡對身體健康至關重要。他特別指出，現今的飲食中Omega-6過多，而Omega-3過少，Omega-6/Omega-3比例非常高（＞10）會導致人體內必需脂肪酸嚴重失衡，隨之引起產生各種慢性疾病。許多研究結果表明，通過增加機體組織中的Omega-3脂肪酸或減少Omega-6脂肪酸來均衡Omega-6/Omega-3脂肪酸的比例，對于防治許多危及生命的慢性疾病和促進公眾健康都非常有益。因此，開發和生產富含Omega-3脂肪酸的食品應作為改善民眾營養健康狀況的重要飲食策略，以平衡必需脂肪酸的攝入，從而改善人們的營養和健康狀況。中英雙語閱讀詳見本期P41-P48。

Professor J. Thomas BRENNA presented “Omega-6 for Body,Omega-3 for Brain: Balance for Brain Development in Children”,in which he pointed out that importance of the essential fatty acids(EFAs) and emphasized the importance of the Omega-6 family of linoleic acids for the body, and Omega-3 family of alpha-linolenic acid for the brain including especially its long-chain metabolite,docosahexaenoic acid (DHA). Balanced dietary essential fatty acids are key to health, and especially to brain development in malnourished children. Furthermore, he introduced the Codex Alimentarius/WHO is increasingly recognizing the primacy of brain health and which on basis of recently their research evidence on using balanced fat for Ready-to-Use-Therapeutic Foods used to treat children with severe acute malnutrition. See the article in P7-P22.

Professor Andrew J. SINCLAIR contributed a profound review of “High Linoleic Acid in the Food Supply Worldwide- What are the Consequences?”. According to current status of vegetable oils are the main source of fat intake, many vegetable oils are rich in linoleic acid, therewith, the intake of linoleic acid also increases significantly with the increase of edible vegetable oils consumption. Therefore, he made an in-depth discussion on the advantages and disadvantages of linoleic acid for human health.Regarding imbalances among dietary linoleic acid and n-3 PUFAs as well as lipid mediators derived from these PUFAs, he reminds the public that imbalance intake of linoleic acid may easily lead to sub-health state. See the article in P23-P40.

專欄文章之五：結合近兩年新冠疫情的全球肆掠，英國帝國理工學院的Yi-qun WANG資深研究員、Mark JOHNSON教授、Michael A CRAWFORD教授、英國劍橋大學Hong-wei REN資深研究員和美國農業部農業研究署Walter F. SCHMIDT資深研究員共同撰寫了《關于COVID-19、膜脂質與公眾健康》的評論文章。他們指出，眾所周知細胞的外層膜就是脂質的雙分子層，而冠狀病毒也具有脂質膜。所以病毒復制需要劫持宿主的RNA工具來合成病毒體蛋白，但必須將其包裹在脂質膜中，促其萌生以擴展感染。最近研究表明，某些膜脂肪酸可以抑制其復制活性，并且脂質膜對病毒外殼可能也有最佳的特異性。雖然復制中DNA、RNA 和蛋白質組成不受飲食影響，但脂質膜受其影響。此外，自1960年代以來，研究發現男性對某些必需脂肪酸和膜完整性不足的敏感性高于女性。有證據表明，花生四烯酸和二十二碳六烯酸具有抗病毒、免疫、抗炎、控制血壓和消退素分解素活性。因此，迫切需要考察它們在COVID-19預防和治療中的地位，同時也需重新評估當前膳食指導政策。中英雙語閱讀詳見本期P49-P58。

本專欄由于處在新冠病毒大流行時期組織，難免有不便之處，但卻得到了各國專家們的積極響應。本專欄作者Michael A CRAWFORD教授、Andrew J. SINCLAIR教授、J. Thomas BRENNA教授爽快應邀大力支持，Andrew J. SINCLAIR教授和J. Thomas BRENNA教授在很短時間里就完成了撰稿。中國疾控中心營養所的張堅研究員也高興應邀與我討論專欄構思并賜稿。美國哈佛大學的Jing X. KANG（康景軒）教授聽說這個專欄后，就表示“有興趣也是一種責任”, 克服繁忙工作到凌晨三四點終于擠出時間賜稿。拳拳之心，不忘初心，牢記使命啊！英國倫敦都市大學營養免疫專家Laurence HARBIGE教授在患病期間還不忘積極支持專欄工作，因身體未康復而中斷寫作，本雜志副主編譚洪卓博士代表編輯部對他表示了親切慰問和衷心感謝，并祝愿他早日康復后參與合作交流。

Professor Jing X. KANG from Harvard University USA presented a commentary of “Development and Production of Omega-3 Fatty Acids-Enriched Foods is an Important Dietary Strategy to Improve People’s Nutritional and Health Status”. He described the importance of EFAs, and emphasized the balance of Omega-6 and Omega-3 fatty acids for cellular structure and function. Thus, the relative balance between Omega-6 and Omega-3 fatty acids are critical for good health. However, today’s diet contains too much Omega-6 but too little Omega-3, leading to a severe imbalance with a very high Omega-6/Omega-3 ratio (＞10)in most people. Many lines of evidence suggest that this imbalance is a key factor contributing to the development of modern chronic diseases. Therefore, development and production of foods rich in Omega-3-fatty acids should be considered as a key national health program to balance essential fat intake and thereby improve the nutritional and health status of all people. See the article in P41-P48.

Professors Yi-qun WANG, Mark JOHNSON, Michael A CRAWFORD from the Imperial College, UK, Drs Hong-wei REN from Cambridge University and Walter F. SCHMIDT from USDAARS USA co-authored “On COVID-19 and Membrane Lipids and Public Health”, observing over the global pandemic of coronavirus recent years, they provide us with insights into relationship between virus, membrane lipids, some special fatty acids, nutrition and health. See the article in P49-P58.

This special issue has received generous contributions from experts across the world. A special thanks to Professor Laurence HARBIGE, an expert in Immuno-nutrition at London Metropolitan University, who has been actively supported this special issue.Professors Michael A CRAWFORD, Andrew J. SINCLAIR, and J. Thomas BRENNA were kindly and swiftly agreed to contribute manuscripts, particularly to Professors Andrew J. SINCLAIR and J. Thomas BRENNA who completed special manuscripts within a very short time. To Professor Jian ZHANG, his enthusiasm to this issue and manuscript, and Professor Jing X. KANG of Harvard University and his contribution despite busy schedule and research commitments. Sincerely to remain true to our aspiration and keep our mission firmly in mind for human health!

然而由于時間有限，組稿涉及范圍和內容并非全面，有待進一步改善和深入，也希望廣大國內外同仁和讀者多多交流、共同提高。

——王以群 于英國·倫敦

2022年3月24日

I hope this special issue can inspire and encourage colleagues and readers to discuss and exchange ideas, for improving understanding and application to human health.

——Dr. Yi-qun WANG at London, UK

March 24, 2022