Department of Nutritional Sciences The Pennsylvania State University University Park PA.
Division of Cardiology Department of Medicine University of Florida Jacksonville FL.
J Am Heart Assoc. 2020 Apr 7;9(7):e014433. doi: 10.1161/JAHA.119.014433. Epub 2020 Mar 23.
In the United States, cardiovascular disease (CVD) is the leading cause of death and disability. Suboptimal diet quality is responsible for a greater percentage of CVD-related morbidity and mortality than any other modifiable risk factor. Further troubling are the stark racial/ethnic and socioeconomic disparities in diet quality. This represents a major public health concern that urgently requires a coordinated effort to better characterize the barriers to healthy dietary practices in population groups disproportionally affected by CVD and poor diet quality to inform multifaceted approaches at the government (policy), community environment, sociocultural, and individual levels. This paper reviews the barriers, opportunities, and challenges involved in shifting population behaviors, especially in underserved populations, toward healthy dietary practices. It is imperative that public health policies address the social determinants of nutrition more intensively than previously in order to significantly decrease CVD on a population-wide basis.
在美国,心血管疾病(CVD)是导致死亡和残疾的主要原因。与任何其他可改变的风险因素相比,饮食质量不佳导致的 CVD 相关发病率和死亡率占比更高。更令人担忧的是,饮食质量在种族/民族和社会经济方面存在明显差异。这是一个重大的公共卫生问题,迫切需要协调努力,更好地描述在 CVD 和不良饮食质量发病率不成比例的人群中,健康饮食实践面临的障碍,以指导在政府(政策)、社区环境、社会文化和个人层面采取多方面的方法。本文综述了在人口行为,特别是在服务不足人群中,向健康饮食实践转变所涉及的障碍、机遇和挑战。为了在人群范围内显著降低 CVD,公共卫生政策必须比以往更加强调营养的社会决定因素。