Morgan M, Heller R F, Swerdlow A
Department of Community Medicine, United Medical School, St Thomas's Hospital, London.
J Epidemiol Community Health. 1989 Jun;43(2):162-7. doi: 10.1136/jech.43.2.162.
Coronary heart disease (CHD) mortality has declined in Britain since the early 1970s and followed a reduction in dietary fat intake in the population. We attempted to determine whether there have been changes in dietary fat intakes by social classes and to see whether they correspond to social class changes in CHD mortality, where the greatest reduction has been in the upper social class groups. Dietary fat intake was specially obtained by social class on a household basis from the National Food Survey (NFS) for 1974 and 1981. The decline in saturated fat intake and increase in polyunsaturated fat is shown to have occurred in each social class group, although it was not possible to examine the data separately for men and women. In contrast, the decline in the proportion of current smokers between 1974 and 1980 (from the General Household Survey) was greatest in the higher social classes. Rates of CHD mortality showed the greatest decline among men in social classes I & II over the period 1969/73 to 1979/83. However, despite some problems in the interpretation of the data collected by the NFS, this study shows that recent social class trends in dietary fat intakes are unlikely to account for the differential changes in CHD mortality. Changes in the prevalence of smoking among social classes are more consistent with the change in CHD mortality.
自20世纪70年代初以来，英国冠心病（CHD）死亡率有所下降，这与人群饮食中脂肪摄入量的减少相一致。我们试图确定不同社会阶层的饮食脂肪摄入量是否发生了变化，并观察这些变化是否与冠心病死亡率的社会阶层变化相对应，其中社会阶层较高的群体下降幅度最大。1974年和1981年的全国食物调查（NFS）按家庭层面专门获取了不同社会阶层的饮食脂肪摄入量。结果显示，每个社会阶层群体的饱和脂肪摄入量均有所下降，多不饱和脂肪摄入量有所增加，不过无法分别对男性和女性的数据进行分析。相比之下，1974年至1980年期间（来自综合住户调查），当前吸烟者比例的下降在社会阶层较高的群体中最为明显。在1969/73年至1979/83年期间，社会阶层I和II的男性冠心病死亡率下降幅度最大。然而，尽管全国食物调查收集的数据在解读上存在一些问题，但这项研究表明，近期不同社会阶层饮食脂肪摄入量的趋势不太可能解释冠心病死亡率的差异变化。社会阶层中吸烟流行率的变化与冠心病死亡率的变化更为一致。
