中国健康生活方式预防心血管代谢疾病指南

心血管代谢疾病包括高血压、糖尿病、血脂异常、冠心病、脑卒中等,严重威胁我国居民健康,疾病负担持续增长。健康的生活方式是预防和管理心血管代谢疾病的重要基石。本指南主要基于中国人群的研究证据,针对膳食与饮料、身体活动、吸烟饮酒等方面提出建议,旨在促进我国居民采取健康的生活方式,预防心血管代谢疾病,推动健康中国行动的实施。     

糖尿病饮食不用再墨守成规!

糖尿病管理需要照顾到方方面面,其中营养治疗是很重要的。糖尿病患者要合理控制总能量,采用低脂、高膳食纤维、高微量营养素的平衡膳食,这是每一位营养师对糖尿病患者进行健康教育所强调的内容。但是去年美国糖尿病协会（ADA）发布了最新糖尿病营养治疗指南,在这份最新的循证共识声明《糖尿病成人营养治疗建议》中为糖尿病患者的营养治疗提出了新的解释,里面有不少理念是第一次提出,     

7项膳食指南的好建议

<正>健康饮食的新建议强调在个人饮食营养方面和推翻一些既往存在的不正确观念。2015年膳食指南咨询委员会想要改变我们对健康饮食的思考方式。在2015年2月发表的一份报告中,这个联邦营养专家小组提出要更新国家膳食指南的建议。小组鼓励我们全面考虑摄入的整体饮食,而不是专注于个人营养。为此,该委员会建议饮食应     

下一次馆子吃掉两天油盐

2007年,《中国居民膳食指南》发布,建议中国人每天用油应控制在25～30克之间,食盐不超过6克,脂肪摄入在50～75克之间。     

摄盐量与糖尿病微血管并发症研究进展北大核心CSCD

摄盐量在全球范围内的平均值超过世界卫生组织（WHO）推荐标准[1-3]中国居民膳食指南,美国饮食指南咨询委员会和澳大利亚膳食指南建议减少盐的摄入[4-6]。以往研究表明,盐的过量摄入会使盐敏感性个体的血压升高.     

常见豆制品应当怎么吃

我国是大豆的原产国,也是为人类提供大豆食品的发源地。1999年12月．美国食品药品监督管理局（FDA）提出“每日摄入25克大豆蛋白,作为不饱和脂肪和胆固醇膳食的一部分,可减少心脏病发生的风险。”《中国居民膳食指南》一直强调要常吃大豆及其制品,最好天天吃。常食大豆有哪些好处呢？     

摄盐量与糖尿病微血管并发症研究进展

正摄盐量在全球范围内的平均值超过世界卫生组织(WHO)推荐标准~([1-3]),中国居民膳食指南,美国饮食指南咨询委员会和澳大利亚膳食指南建议减少盐的摄入~([4-6])。以往研究表明,盐的过量摄入会使盐敏感性个体的血压升高~([2,7-8])。而高水平的摄盐量可引起血糖调节受损、导致血脂升高和非酒精性脂肪肝发生~([9]),并影响胰岛素水平~([10]),甚至可促进糖尿病(diabetic mellitus,DM)心血管并发症的发生~([11])。     

再论钠盐摄入与心血管病风险关系存在J形曲线吗?

正钠盐摄入过多是高血压发病的重要环境因素之一。近百年来,大量动物实验、流行病学调查和临床研究均证实低盐膳食可以降低血压、预防高血压的发生。减少钠盐摄入作为高血压非药物治疗的重要措施,在全球各大高血压指南中均得到广泛推荐和强调。WHO建议一般人群每日钠摄入量应控制在1 970 mg(约5 g盐)以下[1],中国高血压防治指南也建议高血压患者每日钠摄入量应减少至2 362 mg(约6 g盐)以下[2],如果不能将钠摄入量降至目标水平,至少也应     

柳叶刀:常喝牛奶可使死亡、心梗、中风风险降低达3成

正目前的膳食指南认为应当尽量减少日常全脂食品的摄入量,其中最为常见的就是全脂牛奶。但是牛奶中含有的蛋白质、钙、维生素等丰富的营养元素却又是我们机体所必需的营养物质。那么日常究竟应不应该摄入牛奶等乳制品,摄入多少合适,哪种乳制品对健康最为有益呢?近日来自PURE研究的最新结果对此进行了解答,并发表于2018年9月11日的《柳叶刀》杂志。在此次发布的最新研究中,研究人员对136 384名受试者的日常乳制品相关饮食进行问     

钠摄入与心血管疾病相关性数据为何不一致

为减少全球心血管疾病的负担,极其需要开展以人群为基础的有效干预措施。减少盐的摄入量已经成为首选的目标,许多指南推荐的钠摄入量为2.3克/天或更低。这些指南的阈值主要是基于大量临床试验报告食盐摄入少比摄入中等量的人群血压低。然而,至今仍没有大规模的随机试验确定低钠盐摄入对心血管事件的影响。前瞻性队列研究评估钠摄入量和心血管事件之间相关性的结果一直是不一致的,最近一些研究报告显示低钠盐的摄入(在目前指南推荐的范围内)和心血管死亡的风险增加相关。在最大型的一项研究中发现钠的摄入量与心血管死亡事件及心衰之间存在一种J形相关。尽管在这方面有大量的研究,但对这些数据有不同的解释,一些人则主张重新评估目前的指南推荐。在这篇文章中,我们将探讨钠摄入量与心血管疾病相关性存在不同诠释的潜在原因。类似于其他领域在预防方面的情形,争议很可能仍然得不到解决,直到大型权威性的随机对照试验开展以确定低钠摄入(与中等量钠盐的摄入相比)对心血管疾病发病率的影响。     

Dietary acculturation of Hispanic immigrants in Mississippi

OBJECTIVE: Assisting Hispanic immigrants in making culturally acceptable food choices may affect their health for generations. As a relatively new enclave of Hispanics, Scott County, Mississippi, was chosen to study dietary acculturation and health concerns of immigrants. MATERIAL AND METHODS: The research method consisted of interviews with community representatives (N=11), a focus group (N=6), and interviews with Hispanic immigrants (N=18). RESULTS: Community representatives mentioned availability influenced immigrants' food choices and suggested promoting cultural awareness and offering nutrition classes on local ingredients. Food cost, health concepts, food selection, and eating habits of children were salient themes from the focus group and interviews with Hispanics. Hispanic participants mentioned long work hours affect food selection and that U.S. produce lacks freshness and flavor. CONCLUSIONS: Results indicate that an intervention must be formulated that preserves healthful dietary practices and minimizes the negative health aspects of acculturation to the "American diet"     

Celebratory health technology

There are numerous everyday health technologies (applications designed for people to use in their daily lives) that promote healthy eating habits. From educational games to monitoring applications, these systems often take a corrective approach in that they are designed to fix the problematic aspects of people's interactions with, and thoughts about, food. We propose a complementary approach, termed celebratory health technology design, in which systems promote healthy eating by highlighting positive food interactions, meanings, and values. We present a case study from our research to show the benefit and feasibility of designing celebratory health applications. Our goal is to encourage a more comprehensive approach to everyday health technology design, one that encompasses not only corrective systems, but celebratory applications as well.     

Overall dietary variety and adherence to the Mediterranean diet show additive protective effects against coronary heart disease

Background and aimAlong with the increasing evidence of the cardioprotective effects of the Mediterranean Diet (MD), the scientific interest and advocacy of dietary variety as a potentially healthy eating habit gradually faded, until its complete oblivion in the latest European cardiovascular prevention guidelines. Our study aims to investigate whether dietary variety adds to the “Mediterranean-ness” of the diet in protecting against coronary heart disease (CHD).Methods and resultsIn this case–control Italian study, data on eating habits were collected from 178 patients with CHD and 155 healthy controls, primarily males, frequency matched for age and gender, using the Food Frequency Questionnaire (FFQ) of the European Prospective Investigation into Cancer and Nutrition. Adherence to MD was estimated from FFQ by the Mediterranean Diet Score (MDS), an index developed by Trichopoulou (2003) ranging from 0 to 9, with higher scores indicating a stricter adherence. Overall dietary variety was computed from FFQ as a count of single food items consumed at least once a month. Associations between MDS or overall dietary variety and coronary status were evaluated by logistic regression models adjusted for BMI, physical activity, smoking, education, and caloric intake; the Odds Ratio (OR) for CHD for each 1.5-point increase in MDS was 0.76 [IC 95% 0.59; 0.98], whereas the OR for CHD for each 15-item increase in dietary variety was 0.62 [IC 95% 0.46; 0.84]. Remarkably, adherence to MD and overall dietary variety were independently associated with a significantly reduced chance of CHD.ConclusionDietary Mediterranean-ness and overall dietary variety exhibit additive cardioprotective effects.     

Healthy dietary habits, body mass index, and predictors among nursing students, northeast Thailand

This study aimed to assess body mass index (BMI) of nursing students, and examine the links between health behavior in terms of healthy dietary habits, positive health habits, dieting and BMI. A structured questionnaire was used for obtaining information on dietary habits, positive health habits, demographic characteristic including body weight, and height by administering self-answering questionnaires to all of nursing students in the 1st, 2nd, 3rd, and 4th year-classes of the College of Nursing located in northeast Thailand. Three hundred and eleven female nursing students with an average age of 19.9 (SD = 1.4), had an average BMI of 20.3 kg/m2 (SD = 1.9). Most of the subjects (82.6%) were in the acceptable weight category (BMI > 18.5-24.99 kg/m2), 5.1% underweight (BMI < or = 18.5 kg/m2), and 2.3% overweight. (BMI > or = 25.0 kg/m2). About half of them (50.8-66.2%) practiced healthy dietary habits in terms of avoiding eating fat/cholesterol, enriched fiber foods, while one-fourth practiced daily fruit consumption. Positive health habits in terms of having breakfast, and taking exercise over the last two weeks, were practiced by 49.5% and 59.8%, respectively. Persistent health problem occurred 13.5% amongst the subjects. The univariate analyses revealed significant associations between dieting with the BMI; perception of body size with the BMI; the enriched fiber food consumption with dieting; and the avoidance of fat/cholesterol with dieting. It suggests that the choice of food was predominantly attributable to dieting. Results from multiple logistic regression analysis showed that dietary belief, dieting, and exercise had effects on the strength of the association (p = 0.0191, 0.0024, 0.0165; Odds ratios = 0.97, 2.21, 1.87, respectively). The results and implications are discussed.     

Vegetarian Dietary Patterns as a Means to Achieve Reduction in Cardiovascular Disease and Diabetes Risk Factors

Cardiovascular disease and type 2 diabetes are uncommon in people consuming vegetarian and vegan diets. Vegetarian and vegan dietary patterns tend to result in lower body weight and better nutritional profiles than conventional healthy eating patterns and have been shown to be an effective tool for management of cardiovascular disease and diabetes risk. The consistency of observed beneficial outcomes with vegetarian and vegan eating styles warrants the expansion of dietary guidelines for prevention and treatment of cardiovascular disease and diabetes to include well-planned vegetarian dietary patterns as a viable alternative to conventional dietary treatments.     

Role of Childhood Food Patterns on Adult Cardiovascular Disease Risk

Accumulating evidence indicates that childhood nutrition plays a role in the adulthood cardiovascular health. A lifelong tracking of dietary habits, following a long-term exposure to unhealthy dietary patterns or independent effects, is a potential effect-mediating mechanism. Dietary patterns have been studied by data-driven and hypothesis-based approaches. Typically, either data-driven healthy or prudent childhood dietary patterns have been characterized and found to be associated with lower adulthood cardiovascular disease (CVD) risk in the published cohort studies. With regard to the individual food groups or food quality indices, intakes particularly of vegetables and fruits (or fiber indicating plant food intake) and polyunsaturated fatty acids have shown protective effects. The evidence which could confirm the long-term healthiness of a hypothesis-based Mediterranean diet is limited, requiring further investigation. Overall, the recent literature strengthens the view that a healthy childhood diet is associated with lowered adulthood CVD risk.     

Low adherence of a clinically healthy Italian population to nutritional recommendations for primary prevention of chronic diseases

Background and aimSeveral data demonstrated that dietary habits significantly affect the health state of the population. During recent years all the major scientific associations have provided nutritional recommendations for primary prevention of chronic diseases but few data are available about prevalence of adherence to these recommendations in an otherwise healthy population. The aims of this study were to evaluate dietary habits, and to assess the adherence of the general population to the recommendations for correct nutritional behaviour.Methods and resultsDietary habits, anthropometric and biochemical parameters were evaluated in a population of 932 (367 M; 565 F) clinically healthy subjects living in Florence, enrolled in an epidemiologic study conducted between 2002 and 2004. By comparing the dietary pattern with the nutritional guidelines, the study population reported a hyperproteic and hyperlipidic nutritional pattern, with a considerably low contribution from polyunsaturated fats (PUFA). A low fibre intake is shown in both genders. In addition, food consumption pattern showed an increased consumption of some foods such as meat, both fresh and processed, and a low intake of some “healthy” foods like fruit and vegetables.ConclusionsWe found several nutritional flaws in the dietary habits of a clinically healthy Italian population. In particular, we reported a high intake of animal protein and total fats with a very low contribution from PUFA.     

Healthy Food Procurement Policy: An Important Intervention to Aid the Reduction in Chronic Noncommunicable Diseases

In 2010, unhealthy diets were estimated to be the leading risk for death and disability in Canada and globally. Although important, policies aimed at improving individual's skills in selecting and eating healthy foods has had a limited effect. Policies that create healthy eating environments are strongly recommended but have not yet been effectively and/or broadly implemented in Canada. Widespread adoption of healthy food procurement policies are strongly recommended in this policy statement from the Hypertension Advisory Committee with support from 15 major national health organizations. The policy statement calls on governments to take a leadership role, but also outlines key roles for the commercial and noncommercial sectors including health and scientific organizations and the Canadian public. The policy statement is based on a systematic review of healthy food procurement interventions that found them to be almost uniformly effective at improving sales and purchases of healthy foods. Successful food procurement policies are nearly always accompanied by supporting education programs and some by pricing policies. Ensuring access and availability to affordable healthy foods and beverages in public and private sector settings could play a substantive role in the prevention of noncommunicable diseases and health risks such as obesity, hypertension, and ultimately improve cardiovascular health.     

Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood

The palatable, energy‐dense foods that characterize modern environments can promote unhealthy eating habits, along with humans' predispositions to accept sweet tastes and reject those that are sour or bitter. Yet food preferences are malleable, and examining food preference learning during early life can highlight ways to promote acceptance of healthier foods. This narrative review describes research from the past 10 years focused on food preference learning from the prenatal period through early childhood (ages 2–5 years). Exposure to a variety of healthy foods from the start, including during the prenatal period, early milk‐feeding and the introduction to complementary foods and beverages, can support subsequent acceptance of those foods. Yet development is plastic, and healthier food preferences can still be promoted after infancy. In early childhood, research supports starting with the simplest strategies, such as repeated exposure and modelling, reserving other strategies for use when needed to motivate the initial tasting necessary for repeated exposure effects to begin. This review can help caregivers and practitioners to promote the development of healthy food preferences early in life. Specific implementation recommendations, the role of individual differences and next steps for research in this area are also discussed.     

Healthy eating practices: perceptions, facilitators, and barriers among youth with diabetes

PURPOSE: The purpose of this study was to explore the perceptions of healthy eating by youth with diabetes as well as facilitators of and barriers to healthy eating behavior. METHODS: One hundred forty youth aged 7 to 16 years with diabetes participated in 18 focus groups. Sample race/ethnicity was 71% white, 18% African American, 6% Hispanic, and 5% other; 69% of the participants were female. RESULTS: Healthy eating was defined primarily in terms of eating fruits and vegetables, low fat, low sugar, and eating to keep blood sugar in range. However, there were notable differences in perceptions of healthy eating versus perceptions of eating practices good for diabetes management. Specifically, "free" foods (foods high in fat but low in carbohydrate) were commonly reported as being good for diabetes management. Major barriers to healthy eating included widespread availability of unhealthy foods, preparation time, and social situations. Parental behaviors, including monitoring food choices and positive modeling, were the most commonly reported facilitators of healthy eating. CONCLUSION: Findings suggest that youth with diabetes have a general understanding of healthy eating and face similar barriers and facilitators to healthy eating as nondiabetic children do. However, the diabetes regimen may influence their understanding of healthy eating, sometimes negatively. Diabetes nutrition education sessions should emphasize the connection between healthy eating and both short- and long-term diabetes outcomes, and they should highlight strategies to reduce saturated fat consumption while avoiding excessive carbohydrate consumption. The diabetes educator can play an integral role in promoting healthy dietary practices by facilitating parental involvement, designing action plans for managing social situations, and increasing awareness of healthier alternatives to widely available unhealthy foods.