dos Santos J E, Dressler W W, Viteri F, Preto R
Faculdade de Medicina de Ribeirão Preto-USP.
Arq Bras Cardiol. 1994 Nov;63(5):371-5.
To examine the relationships between diet, sociocultural factors, and the major coronary artery disease (CAD) risk factor: arterial blood pressure, serum lipids, and cigarette smoking.
Four residential areas that sampled groups differing in their economic-sector participation were identified. Twenty families of each group were evaluated: "bóias-frias", agricultural labourers employed full-time on a plantation outside the city, factory workers and bank employees. Blood samples and other medical data were obtained either in health centers or in the work places. All blood samples were 12-16h fasting samples. Standard techniques were used to analyse total cholesterol, triglycerides and high-density lipoprotein cholesterol. Dietary intake was estimated for each individual as an average of four 24h dietary recalls. These recalls, collected by trained nutritionists were converted to nutrient intake using USDA food tables, supplemented with Brazilian foods. Lifestyle incongruety was calculated from two components scores: a scale of style of life and a measure of household occupational class. Lifestyle incongruety is calculated by subtracting occupational class from style of life. Social support was assessed by asking respondents to whom they would turn to help in response to a variety of common problems. People with high social support and low lifestyle incongruety were classified as low social stress; people with low social support and high lifestyle incongruents as high social stress.
Higher dietary cholesterol, percent calories in the diet from polyunsaturated fat, calcium intake, and fiber intake were related to serum lipid; socioeconomic status to dietary intake; high social stress to higher diastolic blood pressure and an unfavorable pattern of serum lipids and smoking to age, sex, socioeconomic status, and lifestyle incongruety.
The process by which social change leads to an increased risk of CAD, and the specific behaviors of individuals could be altered to lower their risks.
研究饮食、社会文化因素与主要冠状动脉疾病（CAD）风险因素之间的关系，这些风险因素包括动脉血压、血脂和吸烟。
确定了四个居民区，这些居民区的样本群体在经济部门参与情况上存在差异。对每组的20个家庭进行了评估：“流动厨房”人员，即全职受雇于城外种植园的农业劳动者、工厂工人和银行雇员。在健康中心或工作场所采集血样和其他医疗数据。所有血样均为禁食12 - 16小时后的样本。采用标准技术分析总胆固醇、甘油三酯和高密度脂蛋白胆固醇。通过对每个个体进行四次24小时饮食回忆的平均值来估计饮食摄入量。由训练有素的营养师收集的这些回忆信息，使用美国农业部食品表并补充巴西食物，转换为营养摄入量。生活方式不一致性由两个成分得分计算得出：生活方式量表和家庭职业阶层衡量指标。生活方式不一致性通过用生活方式减去职业阶层来计算。通过询问受访者在面对各种常见问题时会向谁求助来评估社会支持。社会支持高且生活方式不一致性低的人被归类为社会压力低；社会支持低且生活方式不一致性高的人被归类为社会压力高。
饮食中较高的胆固醇、多不饱和脂肪占饮食热量的百分比、钙摄入量和纤维摄入量与血脂有关；社会经济地位与饮食摄入量有关；社会压力高与舒张压升高以及血脂不良模式有关，吸烟与年龄、性别、社会经济地位和生活方式不一致性有关。
社会变革导致CAD风险增加的过程，以及个体的特定行为可以改变以降低其风险。
