Bodenheimer T
University of California, School of Medicine, San Francisco.
West J Med. 1991 Mar;154(3):344-8.
Coronary heart disease has been proved to be associated with a "high-risk" diet and with elevated blood cholesterol levels. The National Cholesterol Education Program has embarked on a campaign based on intensive medical treatment of 60 million Americans with high blood cholesterol levels, but the degree of benefit of dietary change or pharmaceutical intervention or both to reduce blood cholesterol values remains a subject of disagreement within the scientific community. Evidence from comparative international studies suggests that to lower coronary heart disease mortality substantially, dietary alterations and general societal changes must be greater than those possible under the National Cholesterol Education Program's approach of physician-centered patient counseling. The nation's priority to prevent coronary heart disease should be a public policy approach, the goal of which is to reduce for the entire population all coronary disease risk factors. In the dietary area, three proposals to reduce the availability of atherogenic foods are the use of warning labels on atherogenic foods, the prohibition of advertising for such high-risk foods, and the imposition of an excise tax on the same foods. We must confront the "TV-auto-supermarket society" that underlies our nation's high rate of coronary heart disease.
冠心病已被证明与“高风险”饮食以及血液胆固醇水平升高有关。国家胆固醇教育计划已开展一项运动，对6000万血液胆固醇水平高的美国人进行强化药物治疗，但饮食改变或药物干预或两者结合以降低血液胆固醇值的益处程度，在科学界仍是一个存在分歧的问题。来自国际比较研究的证据表明，要大幅降低冠心病死亡率，饮食改变和社会总体变革必须比国家胆固醇教育计划以医生为中心的患者咨询方法所能实现的更大。国家预防冠心病的首要任务应是采取公共政策方法，其目标是降低全体人口的所有冠心病风险因素。在饮食领域，减少致动脉粥样硬化食物供应的三项提议是：在致动脉粥样硬化食物上使用警示标签、禁止此类高风险食物的广告以及对相同食物征收消费税。我们必须面对构成我国冠心病高发病率基础的“电视-汽车-超市社会”。
