Green M S
Israel Center for Disease Control, Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Public Health Rev. 1998;26(1):31-40.
Cancer, ischemic heart disease, cerebrovascular disease and diabetes together comprise almost 70% of the causes of death in Israel. Dietary factors such as total caloric intake, saturated fats, polyunsaturated fatty acids, trace elements, vitamins, certain proteins, and fiber have all been suggested as playing a role in the pathogenesis of these diseases.
In this study, patterns of mortality and morbidity (where available) for selected diseases were compared between the Jewish and Arab population groups in Israel.
Data on cause-specific mortality in Israel between 1973 and 1994 were obtained from the Israel Central Bureau of Statistics. Age-adjusted rates for selected diseases were compared between the Jewish and Arab population groups.
Until 1987, the age-adjusted ischemic heart disease mortality rates in the Arab population were slightly lower than those in the Jewish population. Since 1990, they have been slightly higher. Cerebrovascular disease mortality rates have consistently been higher in the Arab population and the gap has been increasing. Similarly, the mortality rates for diabetes mellitus were slightly higher in the Arab population during the 1970 and 1980s and the gap has increased markedly. On the other hand, age-adjusted mortality rates from colorectal cancer are about three times as high and breast cancer mortality rates about twice as high in the Jewish population. The differences for incidence rates are even greater.
This study demonstrates the contradictory mortality rates for cardiovascular disease as compared with colon and breast cancer in the Jewish and Arab population. While representative dietary data for the populations are lacking, there is evidence that the dietary patterns of the Jewish and Arab population groups differ in many important aspects. It is possible that this may at least partly explain the contradictory differences in mortality and morbidity. The national nutrition surveys currently being initiated by the Ministry of Health should contribute to a better understanding of this subject.
癌症、缺血性心脏病、脑血管疾病和糖尿病加起来几乎构成了以色列70%的死因。诸如总热量摄入、饱和脂肪、多不饱和脂肪酸、微量元素、维生素、某些蛋白质和纤维等饮食因素都被认为在这些疾病的发病机制中起作用。
在本研究中，比较了以色列犹太人和阿拉伯人群中某些选定疾病的死亡率和发病率（如可获得）模式。
从以色列中央统计局获得1973年至1994年以色列特定病因死亡率的数据。比较了犹太人和阿拉伯人群中选定疾病的年龄调整率。
直到1987年，阿拉伯人群中年龄调整后的缺血性心脏病死亡率略低于犹太人群。自1990年以来，该死亡率略高于犹太人群。阿拉伯人群中的脑血管疾病死亡率一直较高，且差距不断扩大。同样，在20世纪70年代和80年代，阿拉伯人群中糖尿病的死亡率略高，且差距显著增加。另一方面，犹太人群中结直肠癌的年龄调整死亡率约为阿拉伯人群的三倍，乳腺癌死亡率约为两倍。发病率的差异甚至更大。
本研究表明，犹太人和阿拉伯人群中心血管疾病的死亡率与结肠癌和乳腺癌的死亡率存在矛盾。虽然缺乏这些人群具有代表性的饮食数据，但有证据表明犹太人和阿拉伯人群的饮食模式在许多重要方面存在差异。这可能至少部分解释了死亡率和发病率的矛盾差异。卫生部目前正在开展的全国营养调查应有助于更好地理解这一问题。
