Ingabe Ukudla Okuphansi Kunamafutha?
Kusukela ngo-1977, bobabili uhulumeni wase-US kanye ne-American Heart Association (AHA) bachitha iminyaka engaphezu kwengu-30 banxusa abaseMelika ukuba banciphise inani lamafutha abadla ekudleni kwabo, okungabi ngaphezu kuka-25 kuya ku-35% wekhalori yansuku zonke. Lesi sincomo, esasithule ngokuthula ngonyaka ka-2010, sisekelwe emcabangweni wokuthi, njengoba amafutha okudla ekhulisa amazinga e-cholesterol, ukunciphisa ukusetshenziswa kwamandla kunganciphisa ingozi ye-atherosclerotic cardiovascular disease.
Naphezu kwalezi zincomo ezinde, ubufakazi besayense obunciphise kakhulu amafutha okudla buthaka ingozi yokuthola isifo sokuqina kwesifo sofuba - futhi kuhlale kube buthakathaka kakhulu.
Izincomo zikaHulumeni mayelana namafutha okudla
Isiphakamiso esihlelekile sokuthi bonke abantu kufanele bavimbele inani eliphelele lamafutha ekudleni kwethu okokuqala kwenziwa ngeCongress yiKhomishana yaseMcGovern, ngo-1977 emva kokuchungechunge kokulalelwa kokudla kanye nempilo, yanyathelisa uhlelo lokuqala lwezinhloso zokudla ze-United States . Ngaleso sikhathi kwaziwa ukuthi ukudla amafutha agcweleyo kwandisa ama-cholesterol amazinga, ngakho-ke (kucatshangwa), ukudla amafutha agcwele kungabangela izifo ze-coronary artery (CAD). (Lokhu kuthathwa akuzange kubambelele kwizifundo ezalandela.)
Ngisho no-1977 ososayensi bebazi ukuthi akuwona wonke amafutha "akubi," futhi ngempela ukuthi amafutha athile ayadingeka empilweni enhle yempilo. Kodwa iKhomishana yaseMcGovern inqume ukunciphisa wonke amafutha okudla, kokubili ukunciphisa isifo senhliziyo futhi (kucatshangwa ngokungalungile) ukulwa nokukhuluphala ngokweqile.
Babesaba ukuthi bazovele badibanise umphakathi ngokuzama ukuveza umlayezo onzima kakhulu amafutha amaningi okufanele agwenywe, kodwa amanye amafutha ayadingeka. Ngakho-ke, umlayezo osemthethweni waqala ukugwema amafutha ngokuphelele, futhi esikhundleni sokuthembela kakhulu kuma-carbohydrates amaningi enkolweni yethu yokudla.
Le mfundiso ephansi-fat-high-carb inqotshwe iminyaka eminingi engu-40 elandelayo, ne-imprimatur yohulumeni bobabili base-US kanye ne-AHA.
Ubufakazi
Naphezu kwalezi zincomo ezinde futhi ezithandwayo ezitholakala ekudleni okunamafutha aphansi, izifundo ezalandela zihlulekile ukuthola noma yikuphi ubufakazi obunamandla bokuthi amazinga aphezulu amafutha adlayo abangela i-CAD. Nazi ezinye zezifundo eziphawulekayo kulokhu:
Isifundo Sezempilo Sezingane ezingama-20, isifundo seqembu esithinta abesifazane abangu-80 000, asibonisi ukulungiswa phakathi kwesifo senhliziyo kanye namafutha okudla. Ukuhlaziywa kwe-meta esilandelayo kwezifundo eziningana zezinhlangano ezifanayo akubonisi ukuhlangana phakathi kwesifo senhliziyo nesifo senhliziyo noma ukufa.
Esivivinyweni esinzima kakhulu esake senziwa ukutadisha amanoni okudla, i-Women's Health Initiative yenzelwe abesifazane abangaphezu kuka-48,000 ekudleni okunamafutha aphansi (futhi basebenzisa ukuguqulwa kokuziphatha okukhulu ukuze banciphise amafutha angama-altare angama-20%, nokwandisa ukusetshenziswa kwezinhlamvu kanye nemifino) noma eqenjini lokulawula elithola imfundo yokudla "evamile" kuphela (leli qembu lokulawula lidla ama-37% ekudleni kwawo ngamafutha). Ngemuva kweminyaka engu-8, kwakungekho ukunciphisa ingozi ye-CAD eqenjini eliphansi lamafutha. Eqinisweni, ukujwayela kwakukhona engozini enkulu.
Okunye ukulingwa okungahleliwe kuye kwahluleka ukubonisa inzuzo ekudleni okunamafutha aphansi.
Ucwaningo olungeziwe luye lwahluleka ukubonisa ingozi enciphise yomdlavuza nge-fat-fat diet, noma ukuthi ukudla okunamafutha aphansi kuhlotshaniswa nokukhuluphala kancane.
Ngamafuphi, emva kokufunda okuyizinkulungwane ezimbalwa, abukho ubufakazi obukholisayo bokuthi ukunciphisa amafutha okudla okuphelele kunamaphesenti angaba ngu-30 - 35% wekhalori yansuku zonke kubeka ingozi yesifo senhliziyo, umdlavuza noma ukukhuluphala.
Kuthiwani Ngokudla Kwe-Ornish?
Ukudla kwe-Ornish, nezinye izinto ezihlukahlukene zokudla okunama-ultra-low, kubizwa ngokumangalisayo ukuthi akugcini kuphela ukuvimbela i-CAD, kodwa futhi ukuyibuyisela emuva. Lezi zidlo ziyingozi kakhulu ekunqandeni kwawo amafutha okudla - ikakhulukazi ezivela emithonjeni yezilwane - kunalokho okudla okuphansi kwamafutha okuphakanyiswa yi-AHA.
Abagqugquzeli bezinhlobo ze-Ornish-type bathi, ngokufanele, ukuthi izifundo ezingaphumeleli ukubonisa inzuzo nge-AHA-izinhlobo zokudla azisebenzi emidlalweni yabo ephakeme kakhulu yokunciphisa amafutha.
Noma kunjalo, izimangalo zokuthi uhlobo lwe-Ornish-type luboniswe ngempumelelo zizisekelwe emininingwaneni engaphelele engahambisani kahle nokuhlolisiswa komgomo. I-hypothesis yokuthi ukudla okunomsoco ophansi kakhulu wezitshalo okuvimbela noma ukuguqula isifo senhliziyo akuzange kuboniswe ngokucacile noma kungavunyelwe, nakuba kuyi-hypothetical ukuthi kufanele ufunde kabanzi.
Okubalulekile
Ukuncoma ukuthi wonke umuntu kufanele adle ukudla okunamafutha okuphansi kwakusukela ekuqaleni ngokusekelwe kwimiqondo ephuthayo, futhi esinqumweni sokuzinikela ngokucacile ngenxa yokululaza umlayezo. Ngemva kweminyaka engaphezu kwengu-30 yokuzama ukuqinisekisa ukuthi ukudla okunamafutha aphansi kunciphisa isifo senhliziyo, ukuvivinywa kokwelashwa akusekeli izincomo ezinde zokuthi wonke umuntu kufanele abe nokudla okunomthelela ekudleni.
Imihlahlandlela evela kuhulumeni kanye ne-AHA ayisacacisi ukudla okunamafutha aphansi, kodwa namanje uncoma amafutha amanani aphelele futhi asebenzise imikhiqizo yobisi ephansi. NgoFebhuwari, 2015, iKomidi Leziqondiso Zemihlahlandlela Yezokudla (i-DGAC, ikomidi elibuyekeza isayensi yokudla okunomsoco njalo eminyakeni emihlanu egameni likahulumeni wase-US), lanyathelise umbiko walo wamuva. Kulombiko, noma yikuphi ukuphakanyiswa kokudla okunamafutha aphansi akusobala. Esikhundleni salokho, i-DGAC ithi, "... iseluleko sokudla kumele sigcizelele ekuthuthukiseni izinhlobo zamafutha okudla hhayi ekunciphiseni amafutha."
Okungenani mayelana namafutha okudla okuphelele, imihlahlandlela esemthethweni yokudla ekugcineni ibonisa isayensi.
> Imithombo:
> Howard BV, Van Horn L, Hsia J, et al. Iphethini Yokudla Ephansi Nengozi Yezifo Zenhliziyo: I-Women's Health Initiative Isikhathi Esilungisiwe Sokuguqulwa Kwezindlela Zokulawulwa Kwamakhosikazi. I-JAMA 2006; 295: 655.
Oh K, Hu FB, Manson JE, et al. Ukutholakala Kwamafutha Okudla Neengozi Yezifo Zezinhliziyo ZaseCoronary Women: Iminyaka Engama-20 Yokulandelwa Kwesifundo Sezempilo Sabahlengikazi. Am J Epidemiol 2005; 161: 672.
> Ornish D, Scherwitz L, Billings J, et al. Ukushintsha Kwendlela Yokuphila Yokushintsha Ukuguquka Kwezifo Zezinhliziyo ZaseCoronary Ukulandelwa Kweminyaka Engu-5 Ye-Lifestyle Heart Trial. I-JAMA 1998; 280: 2001-2007
I-Skeaff CM, i-Miller J. Dietary Fat ne-Coronary Heart Cisease: Isifinyezo sobufakazi obuvela ku-Cohort Esivelayo kanye Nezivivinyo Ezilawulwa Ngemihla. I-Ann Nutr Metab 2009; 55: 173.