《美国食物指引》原文,英文版

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血管保健  三对策
高血压、高血脂和高血糖,统称为“代谢综合症”。这三高之间互相牵连,难分难解,共同做恶,致使血管冠状动脉硬化程度加剧。医学报告已经证实,高血脂除了会导致心脏病之外,与脑血管疾病、高血压及糖尿病等慢性疾病息息相关。因此,只要有高血压、高血脂或高血糖中任何“一高”,就必须留意有罹患其它“两高”的可能性。对此,除了定期检查“三高”外,平时还要注意均衡饮食、积极运动来预防“三高”,一见“三高”数据偏高,就应该接受专科医生的治疗。
对策一:饮食控制,运动养生
要诊断血脂异常,只要抽血检查就可以了。血脂正常值:总胆固醇<5.17毫摩尔/升;甘油三酯<1.47毫摩尔/升;低密度脂蛋白<3.36毫摩尔/升;高密度脂蛋白≥1.16毫摩尔/升。如果您已经超过了正常值,代表您的血脂已经异常。
治疗血脂异常的步骤,第一步应该选择非药物疗法,一般至少3--6个月仍然无效后,才进行药物治疗。非药物疗法包括饮食控制、运动养生和戒烟限酒。
1、控制饮食
对于血脂高的人饮食一定要清淡,要低油、低盐,选择低胆固醇食物和避开高胆固醇食物。
①拒绝油腻:油腻食物不但让血脂升高,还会长胖。所以在日常生活中药少吃油炸、油煎或油酥的食物:少吃含有脂高的猪皮、鸡皮、鸭皮、鱼皮、肥肉及奶油。含隐性油脂的各式火锅料、狮子头、点心等也应该少吃。
②炒菜油秘方:炒菜最好用不饱和脂肪酸高的植物油:如橄榄油、花生油、菜籽油等,少用饱和脂肪酸高的动物油。多采用清蒸、水煮、凉拌等不用油或者少用油的烹调方式,搭配橄榄油、酱油、醋来调味。
③减少吃高胆固醇的食物:包括动物内脏(脑、肝、肾等)、蟹黄、鱼子、蛋黄、蛋黄素或饼干等。若干固醇过高,每周以不超过3个鸡蛋为原则。肉类应多选择鱼类及去皮家禽,尽量少用羊、牛、猪等脂肪高的肉类。还要在饮食中常搭配富含ω—3的深海鱼、黄豆及其制品,有助于高血脂的预防和治疗。
研究证明,植物油经过氢化制成人造奶油、烤酥油等,含有反式脂肪酸,对心血管的危害更严重。因此,凡在食品包装上标有“氢化”、“半氢化”、“精制植物油”的字句,均可能含有反式脂肪酸,须当心。
④富含高纤维食物:高纤维食物可在肠道内结合胆固醇,对心血管健康有利。包括未精制的谷类如糙米、全麦面、燕麦、玉米、薏仁等;未加工的黄豆、红豆、绿豆等各种叶类蔬菜、四季豆、胡萝卜等;各类水果如橙子、梨、柚子等。
2、坚持运动
许多研究发现,现代人活动减少,是造成许多慢性病的原因。因为不运动的人比较胖,一般体重增加10%,胆固醇平均增加18.5毫克/分升,冠心病的危险就增加38%;体重增加20%,冠心病的危险就增加86%。不运动的人血管耐受力也比较差,无法承受压力引发的血压升高。所以运动养生十分重要。
①333运动计划:研究指出,要想有效提高心肺功能,最好进行大肌肉群运动项目,如慢跑、游泳、骑自行车等。运动频度要执行333计划,即:每周运动3--5次,每次运动30--60分钟;运动心跳为130次/分钟。只要运动,不管做多久,都比不运动好。
②少量多次分时运动:美国哈佛大学的研究证实,只要消耗的热量够多,每天进行少量多次的分时运动,其效果和一周三次运动一样有效。哈佛大学公共学院对7307名平均66岁的人进行调查,发现每周散步的距离能达到4.8公里,平均每天散步700米,使心血管病的发病率降低10%。
③运动前须做心肺测试:凡年龄在40岁以上,体检学胆固醇过高者,在运动前一定要进行心肺测试。因为有的人血管张力不好,运动时可能会发生运动型高血压,或产生运动诱发型气喘。为防止发生意外,注意在进行各种运动时,都要控制在自己能耐受的范围内,采取渐进式增加,千万不要勉强增加而发生危险。
3、戒烟限酒
吸烟在对于心脏的危害极大,据美国的统计显示,美国所有冠状动脉心脏病死亡报告病例中30%可归于长期吸烟,若患者合并有糖尿病,吸烟引起的死亡可高达60%。研究发现,对比治疗高血压、降胆固醇的药物以及补充阿司匹林预防血栓等,戒烟对预防心血管病再发的成效最高。
任何人都应少喝酒,尤其是甘油三酯高者。虽然研究发现红酒有助于降低心血管疾病,但也仅限于“少喝一点”。事实上,适量饮酒有益健康仅限于健康者。对于患心脏病的人来说,饮酒不仅会增加心脏负担,使血压升高,心肌收缩力降低,还会导致心律失常。酒精还会引发甘油三酯升高,影响代谢,促进动脉硬化进一步恶化。所以,心血管疾病患者还是应戒烟限酒好。
对策二:保护血管
从饮食中摄取所需要的营养来保护血管时最好的,目前也有不少具有降血脂功效的保健食品。
1、保健食品
①鱼油:鱼油有降血脂、减少心血管疾病及中风发作等作用。目前鱼油不仅是一般人的保健食品,还是心血管患者术前术后的保健营养品,但是鱼油过高可能降低血凝结作用,增加出血机会,故需征求医生意见后服用。
②大蒜素:大蒜中含有甲烷蒜基三硫化物,具有扩张血管及降低血压作用,它也能减少血液的凝结。
③大豆蛋白:大豆蛋白可降低体内总胆固醇、甘油三酯能改善动脉粥样硬化。
④红曲:红曲有降低总胆固醇、甘油三酯的作用,但对正在服用抗生素及甲状腺药物者不宜服用。
⑤燕麦:燕麦中含有多种可溶性纤维素及优质蛋白,可降低血中胆固醇及降低血压,每天只要吃一碗燕麦食品,就有降低血胆固醇的作用。
⑥甲壳素:研究证明,每克甲壳素可吸收12克脂肪,效果优于大多数纤维素,既预防了肥胖,也保护了心血管。
⑦花青素:葡萄籽中的抗氧化成份——花青素,是生物类黄酮的一种,抗氧化能力是维生素C和E的100倍,不仅能抗血中脂质过氧化,还能强化血管,甚至阻断癌细胞生长。
⑧茄红素:茄红素有强大的抗氧化作用,也能保护心血管不受脂质过氧化的破坏。
⑨茶多酚:绿茶中的有益成分是茶多酚,茶多酚不仅有抗癌作用,还能减少肝脏合成胆固醇的作用。实验证明,让老鼠连续服绿茶粉53周,体重减轻18%,胆固醇和甘油三酯降低30%,而低密度脂蛋白也降低了20%。
⑩甘蔗原素:它是从甘蔗表皮蜡质及叶中提取的,具有降低总胆固醇、低密度脂蛋白作用,可起到减少动脉粥样硬化的功效。
2、有益心血管的食品
据美国食品局建议,有益于心血管的食品包括粘稠性纤维、植物性蛋白质、植物性固醇、坚果等。粘稠性纤维食物有:番茄、燕麦、何海带,以及茄子、秋葵、木耳等;植物性蛋白质及固醇包括各种豆类、豆腐、豆浆等黄豆制品;坚果包括杏仁、松子及核桃等。
另外,有助于将血压的食物有芹菜、香蕉、菠菜等。近几年研究证实,薏仁也具有降低胆固醇的作用。实验发现,每天只要食用煮熟的薏仁100克,血中胆固醇可明显下降,还有助于降低体重。
研究发现,山楂有降血脂的作用;黑芝麻能维持血管弹性,预防动脉粥样硬化;日本传统的发酵食物纳豆,含有天然的血栓溶解酵素。此外,多吃深海鱼、拌橄榄油生菜、洋葱、青花菜,都有预防心血管疾病的作用。
除饮茶外,富含保护血管的水果有含花青素的红葡萄、草莓、樱桃、复盆子、黑莓、蓝莓登既能保护泌尿道,又能保护心血管,真是一举两得!
对策三:积极治疗,控制三高
控制高血压、高血脂、高血糖,治疗血脂异常非常重要。在经过3--6个月非药物治疗仍无效后,就应该进行药物治疗,以降低总胆固醇,减少低密度脂蛋白及甘油三酯浓度。提高高密度脂蛋白浓度。目前效果最强的降胆固醇药物是他汀类降脂药,常用的有阿托伐他汀、洛伐他汀、普伐他汀、辛伐他汀、佛伐他汀等,可在医生指导下应用。
对于血脂异常的治疗,长期追踪是非常重要的,医生必须根据病情的复杂性,制定追踪计划,使血脂恢复正常。另外,为了避免并发症的发生,遵从医嘱是非常重要的。
为了避免“三高”文明病的发生,中老年人一定要定期检查血脂。40岁以下,每2—3年检查一次;40岁以上,每—2年检查一次;50岁以上每年检查一次,至于高危人群,每半年检查一次。
《健康指南》 2006 3期
《美国食物指引》原文,英文版
Dietary Guidelines for Americans
Although early versions of food-group systems provided practical guidelines for avoiding nutrient deficiencies, they did not directly address the prevention of other diet-related health problems. To deal with this matter, the U.S. Department of Agriculture and the U.S. Department of Health and Human Services have published Dietary Guidelines for Americans to help individuals meet nutrient requirements, promote health, support active lives, and reduce chronic disease risks. The current (1995) report notes that eating is one of life's great pleasures, but that diet is important to health at all stages of life. The Dietary Guidelines apply to food intake over several days and not to single meals or foods. They are:
1. Eat a variety of foods. No single food can supply all the nutrients in needed amounts. To ensure variety and a well-balanced diet, choose foods each day from the five major food groups displayed in the Food Guide Pyramid: vegetables (3-5 servings); fruits (2-4 servings); breads, cereals, rice, and pasta (6-11 servings); milk, yogurt, and cheese (2-3 servings); and meat, poultry, fish, dry beans, eggs, and nuts (2-3 servings). Since foods within each group vary somewhat in nutrient content, it is best to vary one's choices within each group. Vitamin or mineral supplements at or below the RDA are safe but rarely needed by people who eat an appropriate variety of foods. Supplements may be appropriate for certain people, but they are not a substitute for proper food choices.
2. Balance the food you eat with physical activity -- maintain or improve your weight. Obesity is associated with many serious illnesses. Being too thin is linked to osteoporosis in women. For those who are overweight, the recommended loss of 1/2 to 1 pound per week should be accomplished by increasing physical activity and eating less fatty foods; more fruits, vegetables and cereals; less sugar and sweets; and little or no alcohol.
3. Choose a diet with plenty of grain products, vegetables, and fruits. Most of the calories in the diet should come from these foods, which also are low in fat and provide fiber. The daily average for adults should include at least six servings of grain products, three servings of vegetables, and two servings of fruit. Because foods differ in the kinds of fiber they contain, it is best to include a variety of fiber-rich foods. Fiber should be obtained from foods, not supplements.
4. Choose a diet low in fat, saturated fat, and cholesterol. Diets low in fat are associated with a lower risk of heart disease and certain cancers. The recommended limits are a fat intake of no more than 30% of calories, with less than 10% of the calories as saturated fat, and no more than 300 mg of cholesterol daily.
5. Choose a diet moderate in sugars. The only legitimate concern with sugar consumption is tooth decay. However, the risk of tooth decay does not depend simply on the amount of sugar consumed but on the frequency of consumption of sugars and starches and how long they remain in contact with the teeth. Frequent eating of foods high in sugars and starches may be more harmful to teeth than eating them at meals and then brushing. Regular daily dental hygiene, including brushing, flossing, and an adequate intake of fluoride, will help prevent tooth decay. Children who live in communities whose water is not fluoridated should take a fluoride supplement. Individuals whose caloric needs are low should be cautious about eating high-sugar foods that contain unnecessary calories and few nutrients.
6. Choose a diet moderate in salt and sodium. This can be accomplished by learning to enjoy the flavors of unsalted foods, adding little or no salt during cooking or at the table, flavoring foods with herbs or spices, and limiting intake of foods that are obviously salty or contain significant amounts of hidden salt. (The relationship between sodium intake and high blood pressure is discussed later in this chapter.)
7. If you drink alcoholic beverages, do so in moderation. Alcohol itself contains seven calories per gram, and alcoholic beverages provide contain few or no nutrients. Moderate drinking (no more than one drink per day for women and two drinks per day for men) is associated with a lower-than-average risk of coronary heart disease, but higher levels of alcohol intake increase the risk of high blood pressure and stroke and can cause many other problems. Complete abstention is advisable for women who are pregnant or trying to conceive and for people planning to drive a car, engage in another activity that requires attention or skill, or use medications that can enhance alcohol's effects.
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