The common cardiovascular diseases related to dietary nutrition in China are hypertension, stroke and coronary heart disease, which are a group of cardiovascular diseases related to blood pressure and atherosclerosis as the pathological basis, the results of the National Survey on Nutrition and Health of the Population in 2002 showed that the prevalence of hypertension among adults in China reached 18.8%, and it is estimated that there are 160 million patients with hypertension nationwide, and the prevalence increased by 31% compared with 1991. 31%. In 2006, cardiovascular disease accounted for about 1/3 of the causes of death in China’s population and became the first cause of death in urban and rural areas. Epidemiological analysis shows that these common cardiovascular diseases certainly have a genetic predisposition, but it is the environmental factors that determine its distribution characteristics, that is, lifestyle, and more specifically the lifestyle in China is different from that in Western countries, and there is a large difference in lifestyle between different regions of China, especially the type of diet, and the impact of these factors on the development of cardiovascular disease may vary. Among these many environmental factors, dietary nutrition is a relatively important aspect.
I. The role of nutrition on cardiovascular
Nutrition has a very important role in the cardiovascular system, especially in maintaining the structure and function of the cardiovascular system is of great importance.
Nutrition is an important source of energy, normal cardiomyocytes take in nutrients from the blood is the most important free fatty acids, followed by glucose and lactate, in addition to amino acids, ketone bodies and pyruvate, etc. The arterial wall also needs to constantly obtain a variety of nutrients from the blood including protein, sugar fat and cholesterol, etc.
Nutrients are involved in several important physiological and biochemical processes in the cardiovascular system. In addition to a certain amount of energy, the diastolic contraction of the heart muscle requires the participation of certain metal ions such as potassium, sodium and calcium. In addition, some vitamins and trace elements in food are cofactors of several important enzymatic systems in the metabolism of myocardial tissue and arterial walls.
Nutritional deficiencies or excesses can disrupt the normal structure and function of the cardiovascular system, leading to cardiovascular disorders.
Nutritional deficiencies, such as pedal heart disease due to vitamin B1 deficiency, dietary potassium, magnesium and chloride deficiencies can increase the susceptibility of cardiomyocytes to pathogenic factors, thereby inducing primary necrotizing cardiomyopathy, and the local occurrence of Keshan disease in China, a cardiomyopathy of unknown cause, may be related to dietary deficiencies of certain trace elements such as selenium, magnesium, molybdenum, etc. Magnesium deficiency can cause electrocardiographic Magnesium deficiency can cause electrocardiographic abnormalities, promote selective myocardial calcification, induce lethal myocardial spasm and rapid arrhythmias, and vitamin B6 and C deficiency can affect the structural integrity of the arterial wall, etc.
If excess nutrition occurs on the structure and function of the cardiovascular system is also damaging, for example, excess intake of total energy saturated fatty acids, cholesterol and refined cane sugar, etc., easy to induce obesity, hyperlipidemia and atherosclerosis, excessive sodium intake and the onset of hypertension, in addition to recent years also found that certain special food components, such as excess erucic acid can cause myocardial damage in animals.
Second, the main cardiovascular disease risk factors
Risk factors of hypertension
The first is overweight and obesity, domestic and foreign research has proved that overweight is a risk factor for the development of hypertension, since 1990, China has 13 large-scale epidemiological surveys a total of 240,000 adult data concluded that the risk of hypertension for people with BMI ≥ 24 is 3 to 4 times that of people with normal BMI, male waist circumference ≥ 85 cm, female waist circumference ≥ 80 cm such people suffer from The risk of hypertension is about 3.5 times that of people with a waist circumference below this value, which means that being overweight and obese increases the risk of hypertension.
The second is the long-term sustained alcohol consumption, in the front of those just mentioned in the large-scale epidemiological survey also got some conclusions, that is, continued alcohol consumption than non-drinkers male hypertension incidence of such a risk will increase by 40%, many foreign studies also came up with similar results. The long-term sustained alcohol consumption referred to in this refers to the amount of alcohol consumed per day is greater than 30g, which is equivalent to more than one or two bottles of white wine per day.
The third risk factor is dietary high salt and low potassium, dietary high salt and low potassium is one of the important reasons for the high incidence of hypertension in China, especially in the northern region, and domestic studies have shown that the average sodium-potassium ratio in the diet of the population will increase by one unit of systolic blood pressure will rise by 2.9 mmHg and diastolic blood pressure will rise by 1.6 mmHg. The fourth risk factor is normal high blood pressure, which has changed internationally in recent years from the usual classification of hypertension to normal blood pressure of 120 and 80 mmHg, to normal high blood pressure of 120 to 139 mmHg systolic and 80 to 89 mmHg diastolic.
Risk factors for coronary heart disease
The first and foremost is elevated blood pressure
The role of elevated blood pressure in the development of coronary heart disease is continuously increasing, and the risk of coronary heart disease is progressively higher in those with high blood pressure compared to those with normal blood pressure, and elevated blood pressure is an important risk factor for the development of coronary heart disease in both Western and Eastern populations, with a stronger role in Eastern populations.
The second risk factor
is an increase in total serum cholesterol or LDL cholesterol. The pathological change of coronary heart disease is atherosclerosis, in which atheromatous plaque rises from the arterial wall and leads to narrowing of the coronary arteries and insufficient blood supply to the myocardium, and it is now known that the most important lipoprotein that causes atherosclerosis is LDL. Since it is easier to measure total cholesterol in clinical practice, serum total cholesterol concentration is often used as a relative indicator of LDL cholesterol levels. Studies have shown that a serum total cholesterol concentration between 5.2 and 6.1 mmol/L, which is equivalent to LDL cholesterol of 3.4 to 4.1 mmol/L, doubles the risk of coronary heart disease, while a serum total cholesterol concentration ≥6.2 mmol/L triples the risk of coronary heart disease.
The third risk factor
The third risk factor is low serum HDL cholesterol level. HDL can bring cholesterol from arterial wall foam cells to the liver and prevent the formation of atherosclerotic plaque, so it is a protective factor for coronary heart disease, while low HDL cholesterol has been proved to be an independent risk factor for coronary heart disease in many prospective studies.
The fourth risk factor is smoking
Smoking can increase the risk of coronary heart disease. Studies have shown that smoking is one of the four major risk factors for coronary heart disease, and that smoking can cause coronary artery spasm and elevate plasma fibrinogen, which can lead to thrombosis and thus increase the risk of arterial occlusion.
The fifth risk factor
Overweight and obesity are independent risk factors for coronary heart disease, and each unit increase in BMI, or body mass index, is associated with a 12% increase in the risk of developing coronary heart disease. The sixth risk factor is diabetes, such patients tend to have a series of abnormal lipid metabolism, and such a situation will increase the risk of coronary heart disease.
Third, the medical treatment of cardiovascular disease
Hypertensive disease in recent years about hypertension in recent years about the etiology and pathogenesis of hypertension research and prompted people to re-evaluate the important role of nutrition in the prevention and treatment of this disease, mainly because first hypertensive disease as a common disease, its occurrence and environmental factors, especially with nutritional and dietary factors are closely related, the second existing various antihypertensive drugs have certain side effects. The nutritional therapy not only has certain curative effect, but also is physiologically appropriate, so it is more suitable for the prevention and treatment of large-scale people.
The first is to control the total dietary energy and increase physical activity
Control the total energy intake and strong exercise can make and maintain the weight within a normal range, which is very important for the treatment of hypertension, the total energy can be given 20 to 25kcal per kilogram of body weight according to the patient’s ideal weight, or the daily energy intake than the usual reduction of 500 to 1000kcal per meal energy should not be too much, energy reduction should be taken in a gradual way, and not too fast, and not too much. And do not be too hasty and fall too fast. To develop good dietary habits dietary nutrition should be balanced within the limits of energy reasonable arrangement of protein, fat, sugar ratio. Protein should account for about 15% of energy, fat accounts for about 25%, sugar accounts for about 60% to 65%, while inorganic salts and vitamins to meet the DRI standards can be. Also pay attention to the cooking method, choose the kind of cooking methods based on less oil processing methods, such as blanching, boiling, mixing, stewing, etc.. Another very important thing is to do a moderate amount of physical activity every day should be about 3 kilometers of walking, more than 30 minutes, to choose a suitable regular exercise such as cycling, aerobics, tai chi, etc..
The second is to reduce and limit the intake of sodium in the diet
The importance of a low-sodium diet should be widely publicized, and for most hypertensive patients it is recommended that the daily salt intake should be controlled at 2 to 5g, equivalent to one to three taels of salt per month, in addition to salt, the intake of salt-pickled foods should be controlled, such as salted eggs, salted fish, pickles, pickles, etc.
The third method is still to relatively increase the intake of potassium
Potassium can counter the adverse effects of sodium, in the low sodium diet at the same time can be properly supplemented with potassium salt or intake of some high potassium content food. It is recommended that the daily intake of potassium should be about 90 mmol, which is equivalent to 3.5 g. It is generally recommended to avoid potassium deficiency by eating natural foods, especially more vegetables and fruits, such as soybeans, dried cinnamon, raisins, fried peanuts, dried green beans and fresh beans.
There should be enough calcium and magnesium in the diet. Data show that the diet of low calcium in the population, blood pressure is affected by sodium more, so in the choice of food should ensure that there is enough calcium and magnesium intake eat more calcium and magnesium-rich food.
The quality and quantity of protein should meet the needs of patients with hypertension. In the past, a low-protein diet was emphasized for patients with hypertension, but it is now believed that there is no need to strictly limit protein intake except for those with chronic renal insufficiency. Regarding the source of protein should choose more fish soy and its products, for the amount of protein best ideal weight to give 1g protein per kg of body weight per day.
Dietary fat should also be reduced and the intake of food cholesterol and saturated fat should be properly controlled, with food cholesterol preferably limited to 300mg, 300mg per day, and the intake of polyunsaturated fat should be increased.
Limit the consumption of alcohol, patients with hypertension should not drink alcohol, a small amount is recommended to drink low alcohol, the issue of alcohol consumption is not an absolute taboo.
DASH diet because the diet he diet pattern is derived from a study of the prevention of hypertension in the United States, it is experimental subjects for hypertension normal high and mild hypertension, respectively, with the consumption of eight weeks of three meals. The first is the typical American diet, the second is a diet rich in fruits and vegetables, and the third is the DASH diet, which is characterized by a balanced diet containing fruits, vegetables, low-fat dairy, and whole grains, and the results of the study showed that the blood pressure of this diet group was reduced very significantly. It is almost similar to the effect of medication alone, so this dietary pattern is not only used to prevent hypertension but also listed as one of the examples in the 2005 American Dietary Guidelines.
For example, foods high in tyramine, such as cheese, sour cream, lentils, mushrooms, cured meats or fish, beer, red glucose, avocados, bananas, and raisins, should not be consumed during treatment with monoamine oxidase inhibitors because tyramine can trigger the release of norepinephrine from postganglionic sympathetic nerve endings, causing blood pressure to drop. Adrenaline, causing a sharp rise in blood pressure and the serious consequences of hypertensive crisis, in addition to the use of diuretics are likely to cause electrolyte disorders, so the content of sodium and potassium in the diet should be properly adjusted.
Second, prevention and treatment measures for dyslipidemia
The former includes reasonable diet and lifestyle adjustment such as strengthening exercise and quitting smoking, and most people can achieve the purpose of reducing blood lipids through non-pharmaceutical measures. After six months, if the requirements are met, treatment can be continued. If the treatment effect is not satisfactory, lipid-regulating drugs should be added, but at the same time, diet regulation should be adhered to. The first principle of treatment for dyslipidemia is to diversify food, the second is to maintain a balance between food intake and physical activity to maintain an appropriate weight, and the third is to moderately limit sodium intake to no more than 6g of salt per day.
Thirdly, avoid overfeeding with small amount of meals.
Avoid smoking, strong tea and all spicy condiments, advocate drinking a glass of plain water in the morning on an empty stomach to dilute the blood and promote the excretion of waste products from the blood as soon as possible. Fifth, moderate alcohol consumption can increase the level of high-density lipoprotein can inhibit platelet agglutination, the sixth low-fat, low-saturated-fat, low-cholesterol diet arrangement, which means that the energy provided by fat in the diet should account for less than 30% of the total energy. It can be an average value for a week and does not have to be reached every day.
IV. Dietary prevention of cardiovascular disease
In 2006, the American College of Cardiology issued a scientific statement on diet and lifestyle that proposed a new concept of a comprehensive and healthy diet rather than emphasizing a particular nutrient or food.
The specific contents of this statement are.
First, balance energy intake with physical activity to achieve or maintain an appropriate body weight. It is recommended that adults accumulate more than 30 minutes of physical activity per day for most of the week, and for people who are losing weight and for children, at least 60 minutes of physical activity per day.
Second, a diet rich in vegetables and fruits, vegetables and fruits can reduce blood pressure and improve other risk factors, recommended dark vegetables, not recommended fruit juice because in the juice or no dietary fiber or very low dietary fiber is very little, recommended those who can retain nutrients and dietary fiber without adding extra energy sugar, salt, saturated fatty acids and trans fatty acids cooking methods.
Third, choose whole grains and high fiber foods, dietary fiber can delay gastric emptying and increase satiety, leading to a reduction in total energy intake, soluble dietary fiber can moderately reduce LDL cholesterol levels, increase short-chain fatty acid synthesis and thus reduce endogenous cholesterol production, insoluble dietary fiber can reduce the risk of cardiovascular disease and prevent constipation, at least half of the intake of cereals should come from whole grains and their At least half of the cereal intake should come from whole grains and their products.
Fourth, eat fish, especially fish with oil, at least twice a week.
Fifth, limiting the intake of saturated or trans fatty acids and cholesterol suggests choosing lean meats and vegetables, nonfat and low-fat dairy products, beans and fish instead of meat, using less hydrogenated fats, and eating less fried or baked foods.
Sixth, minimize the intake of sugary drinks and foods to reduce the total energy intake to prevent weight gain.
Seventh, choose low-salt or salt-free food so as to help people with low blood pressure to prevent hypertension can also enhance the effect of antihypertensive drugs, reduce the risk of atherosclerosis and heart failure. Eighth, moderate alcohol intake is associated with a reduction in cardiovascular disease, and it is recommended that no alcohol be consumed. If alcohol is needed on special occasions, it is recommended that men should limit it to no more than two drinks per day, and women no more than one drink per day, and preferably with meals.