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食物是良药:美国心脏协会的总统顾问报告

Food Is Medicine: A Presidential Advisory From the American Heart Association.

出版信息

Circulation. 2023 Oct 31;148(18):1417-1439. doi: 10.1161/CIR.0000000000001182. Epub 2023 Sep 28.

Abstract

Unhealthy diets are a major impediment to achieving a healthier population in the United States. Although there is a relatively clear sense of what constitutes a healthy diet, most of the US population does not eat healthy food at rates consistent with the recommended clinical guidelines. An abundance of barriers, including food and nutrition insecurity, how food is marketed and advertised, access to and affordability of healthy foods, and behavioral challenges such as a focus on immediate versus delayed gratification, stand in the way of healthier dietary patterns for many Americans. Food Is Medicine may be defined as the provision of healthy food resources to prevent, manage, or treat specific clinical conditions in coordination with the health care sector. Although the field has promise, relatively few studies have been conducted with designs that provide strong evidence of associations between Food Is Medicine interventions and health outcomes or health costs. Much work needs to be done to create a stronger body of evidence that convincingly demonstrates the effectiveness and cost-effectiveness of different types of Food Is Medicine interventions. An estimated 90% of the $4.3 trillion annual cost of health care in the United States is spent on medical care for chronic disease. For many of these diseases, diet is a major risk factor, so even modest improvements in diet could have a significant impact. This presidential advisory offers an overview of the state of the field of Food Is Medicine and a road map for a new research initiative that strategically approaches the outstanding questions in the field while prioritizing a human-centered design approach to achieve high rates of patient engagement and sustained behavior change. This will ideally happen in the context of broader efforts to use a health equity-centered approach to enhance the ways in which our food system and related policies support improvements in health.

摘要

不健康的饮食是实现美国更健康人口的主要障碍。尽管人们对健康饮食的构成有相对清晰的认识,但大多数美国人的饮食习惯并不健康,不符合推荐的临床指南。大量的障碍,包括食物和营养不安全、食物的营销和广告方式、获得健康食品的机会和可负担性,以及即时满足与延迟满足之间的行为挑战等,都阻碍了许多美国人采用更健康的饮食模式。“食物即药物”可以被定义为提供健康的食物资源,以预防、管理或治疗特定的临床疾病,并与医疗保健部门协调。尽管该领域具有潜力,但相对较少的研究采用了提供食物即药物干预与健康结果或健康成本之间关联的有力证据的设计。需要做大量的工作来建立更有力的证据体系,令人信服地证明不同类型的“食物即药物”干预措施的有效性和成本效益。据估计,美国每年 4.3 万亿美元的医疗保健费用中有 90%用于治疗慢性病。对于许多这些疾病来说,饮食是一个主要的风险因素,因此即使饮食略有改善也可能产生重大影响。本总统顾问报告概述了“食物即药物”领域的现状,并为新的研究计划提供了路线图,该计划从战略上解决该领域的悬而未决的问题,同时优先考虑以人为本的设计方法,以实现患者高参与度和持续行为改变。这最好是在更广泛地利用以健康公平为中心的方法来增强我们的食物系统和相关政策支持改善健康的方式的背景下进行。

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