DIFFERENCES IN CORONARY MORTALITY CAN BE EXPLAINED BY DIFFERENCES IN CHOLESTEROL AND SATURATED FAT INTAKES IN 40 COUNTRIES BUT NOT IN FRANCE AND FINLAND - A PARADOX
DIFFERENCES IN CORONARY MORTALITY CAN BE EXPLAINED BY DIFFERENCES IN CHOLESTEROL AND SATURATED FAT INTAKES IN 40 COUNTRIES BUT NOT IN FRANCE AND FINLAND - A PARADOX
复制标题
DOI：
10.1161/01.cir.88.6.2771
复制
发表时间：
1993-12-01
期刊：
影响因子：
37.8
通讯作者：
CONNOR, WE
中科院分区：
文献类型：
--
作者：
ARTAUDWILD, SM;CONNOR, SL;CONNOR, WE
背景几十年来，芬兰的冠心病（CHD）死亡率比法国高四倍或更多，尽管饮食胆固醇和饱和脂肪的摄入量相当。对这一悖论的一个潜在的答案是通过对40个国家的研究以及对饮食中除胆固醇和饱和脂肪外的其他营养素的分析提供的。55至64岁男性的冠心病死亡率来自世界卫生组织的年度生命统计数据。膳食摄入量来自联合国粮食及农业组织数据库。对处于不同经济发展水平的40个国家和40个饮食变量进行了调查，包括结合胆固醇和饱和脂肪摄入量的脂质评分（胆固醇-饱和脂肪指数[CSI]）。在40个国家中，CSI与CHD死亡率显著正相关。低CSI的国家CHD死亡率较低。具有高CSI的国家具有广泛的CHD死亡率。法国、芬兰和其他西方工业化国家也有类似的CSI。在调整胆固醇和饱和脂肪后，牛奶和牛奶的许多成分（乳脂、牛奶蛋白、牛奶中的钙和核黄素）以及总钙仍然与所有40个国家的冠心病死亡率呈正相关。在法国和芬兰，这些食物和营养素的消费量存在差异。芬兰的牛奶和乳脂（来自牛奶、奶油、奶酪和黄油的脂肪）消费量高于法国。植物性食品的消费，最近被证明是预防冠心病（蔬菜和植物油含有单不饱和和多不饱和脂肪酸），是在法国比在芬兰。多年来，普兰斯和芬兰的胆固醇和饱和脂肪摄入量相似，但冠心病死亡率却一直存在很大差异。这个矛盾可以解释如下。考虑到胆固醇和饱和脂肪的高摄入量，人们还消费更多植物性食物（包括少量液体植物油）和更多蔬菜（更多抗氧化剂）的国家冠心病死亡率较低。另一方面，牛奶和乳脂与冠心病死亡率增加有关，可能是通过它们对血栓形成和动脉粥样硬化的影响。
Background. For decades, the coronary heart disease (CHD) mortality rate has been four or more times higher in Finland than in France despite comparable intakes of dietary cholesterol and saturated fat. A potential answer to this paradox is provided by this study of 40 countries and the analyses of other nutrients in the diets besides cholesterol and saturated fat.Methods and Results. CHD death rates for men aged 55 to 64 years were derived from the World Health Organization annual vital statistics. Dietary intakes were gathered from the Food and Agriculture Organization of the United Nations database. Forty countries at various levels of economic development and 40 dietary variables were investigated, including a lipid score that combined the intakes of cholesterol and saturated fat (Cholesterol-Saturated Fat Index [CSI]). The CSI was significantly and positively related to CHD mortality in the 40 countries. The countries with low CSIs had low CHD death rates. Countries with high CSIs had a wide range of CHD death rates. France, Finland, and other Western industrialized countries had similar CSIs. After adjusting for cholesterol and saturated fat, milk and many components of milk (butterfat, milk protein, calcium from milk, and riboflavin) and total calcium remained positively related to CHD mortality for all 40 countries. There were differences in the consumption of these foods and nutrients in France and Finland. Milk and butterfat (fat from milk, cream, cheese, and butter) consumption was higher in Finland than in France. The consumption of plant foods, recently shown to be protective against CHD (vegetables and vegetable oils containing monounsaturated and polyunsaturated fatty acids), was greater in France than in Finland.Conclusions. Over the years, Prance and Finland, with similar intakes of cholesterol and saturated fat, consistently have had very different CHD mortality rates. This paradox may be explained as follows. Given a high intake of cholesterol and saturated fat, the country in which people also consume more plant foods, including small amounts of liquid vegetable oils, and more vegetables (more antioxidants) had lower rates of CHD mortality. On the other hand, milk and butterfat were associated with increased CHD mortality, possibly through their effects on thrombosis as well as on atherosclerosis.