Roberts D C
Human Nutrition Unit, University of Sydney, NSW, Australia.
Prostaglandins Leukot Essent Fatty Acids. 1991 Oct;44(2):97-101. doi: 10.1016/0952-3278(91)90190-g.
The role of dietary change in the fall in heart disease mortality has been hotly debated. Three countries, Australia, USA and UK with equal 'care' and sophistication of surgical techniques have shown different timing in the beginning of the decline of this 'epidemic'; around the mid 1960s in the first two countries, but not until the late 1970s for the UK. The cause of this difference may be the changing food habits of their populations. Using food disappearance data, apparent consumption of butter and margarine show opposite trends (butter down and margarine up) predating the decline in mortality in both the USA and Australia by at least 7 years and also in the UK, but at a later time, (about 1970). Changes in adipose tissue linoleate, a marker for polyunsaturated fat intake, support this indirect evidence, with depot levels rising in the USA from the 1960s and 10 years later in the UK. Other evidence support the view of decreasing saturated fat intake and increasing polyunsaturated intake prior to 1960 in the USA. Although many factors must contribute to the decline in mortality from CHD, change in dietary P/S ratio would seem to be the major dietary contributor.
饮食变化在心脏病死亡率下降中所起的作用一直备受争议。澳大利亚、美国和英国这三个国家在外科手术技术方面具有同等的“关注度”和成熟度，但在这种“流行病”开始下降的时间上却有所不同；前两个国家大约在20世纪60年代中期开始下降，而英国直到20世纪70年代末才开始。这种差异的原因可能是其人口饮食习惯的变化。利用食物消失数据，黄油和人造黄油的表观消费量呈现出相反的趋势（黄油下降，人造黄油上升），在美国和澳大利亚，这种趋势至少比死亡率下降提前7年出现，在英国也是如此，但时间稍晚（约1970年）。脂肪组织亚油酸（多不饱和脂肪摄入量的一个指标）的变化支持了这一间接证据，美国的储存水平从20世纪60年代开始上升，英国则在10年后上升。其他证据支持了美国在1960年之前饱和脂肪摄入量下降和多不饱和脂肪摄入量增加的观点。尽管许多因素肯定对冠心病死亡率的下降有影响，但饮食中P/S比值的变化似乎是饮食方面的主要因素。
