Division of Metabolism and Nutrition, Department of Internal Medicine, The Jikei University Graduate School of Medicine, Tokyo, Japan.
J Atheroscler Thromb. 2011;18(9):723-34. doi: 10.5551/jat.8193. Epub 2011 Jun 17.
To demonstrate the reasons for low morbidity and mortality from coronary artery disease (CAD) and reconfirm the effectiveness of the Japanese dietary lifestyle for preventing CAD, we herein review the CAD risk transition, and post-war changes in Japanese food and nutrient intake. Large-scale cohort studies in Japan were selectively reviewed. Low serum total cholesterol contributed to preventing CAD, and decreased blood pressure was the major factor favoring stroke reduction. Japanese consumed more plant and marine origin foods, but fewer animal foods with saturated fatty acids (SFA) during the 1960-70s than in recent decades. Adequate control of total energy with restriction of saturated fatty acids from animal foods, increased intake of n-3 polyunsaturated fatty acids, including fish, soybean products, fruits and vegetables together with low salt intake are responsible for promoting CAD and stroke prevention. A diet with adequate total calories and increased intake of fish and plant foods, but decreased intake of refined carbohydrates and animal fat, a so-called Japan diet, appears to be quite effective for prevention of CAD risk factors and is recommended as dietary therapy for preventing CAD.
为了阐明冠心病（CAD）发病率和死亡率低的原因，并再次确认日本饮食生活方式预防 CAD 的有效性，我们在此回顾了 CAD 风险的转变，以及战后日本食物和营养摄入的变化。本文选择性地综述了日本的大规模队列研究。血清总胆固醇水平低有助于预防 CAD，而降低血压是减少中风的主要因素。20 世纪 60 年代至 70 年代，日本人食用的植物性和海源性食物比最近几十年多，但动物性食物和饱和脂肪酸（SFA）摄入较少。通过限制动物食物中的饱和脂肪酸，控制总能量摄入，增加 n-3 多不饱和脂肪酸的摄入，包括鱼类、豆制品、水果和蔬菜，同时减少盐的摄入，这有助于促进 CAD 和中风的预防。摄入足够的总热量，增加鱼类和植物性食物的摄入，减少精制碳水化合物和动物脂肪的摄入，即所谓的日本饮食，对于预防 CAD 危险因素非常有效，建议作为预防 CAD 的饮食疗法。
