远离心梗脑梗从嘴做起ppt课件.ppt

* Sodium Sensitive People People most likely to be sodium-sensitive: Family history of high blood pressure Chronic kidney disease Diabetes African American Over 50 years of age Overweight * The DASH diet is high in fruits and vegetables, nuts, legumes and low fat dairy products but is also low in saturated fat. The DASH diet reduces blood pressure to a similar extent as a single antihypertensive medication even in the absence of weight loss (as quoted in the CHEP 2004 Recommendations: the bottom line version page 5.. The low sodium DASH diet evaluated the effect of reducing sodium intake in combination with consuming a DASH diet (fruits and vegetables, low fat dairy products, and low in saturated and total fat). The combination diet found that blood pressure fell 11.4/5.5 mmHg in hypertensives compared to 3.5/2.1 in normotensives. Appel et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997;336:1117-1124. * Do these numbers surprise you? Think of what you eat in a day and it is easy to understand how we ingest so much sodium. It is hard to avoid * * 减少盐摄入的好处 ~3,500 mg/day (current) ~1,500 mg/day (AI) 降低高血压发生 30% (CJC 2007 23:437) 每天预防30名美国人因卒中而早死，减少15%所有心脑血管疾病发生的风险 (CJC 2008 24:497) BP? ~5 mmHg 面对新的盐推荐量－多少人能够做到？ 达到２００５推荐标准 所有成人 9.6% 2,300 mg/day推荐 18.8% ≤1,500 mg/day 推荐 5.5% 高血压者 5.9% ４０岁以上非高血压者 5.1% 年轻人 5.7% Source: CDC NHANES unpublished data. 根源在哪里？厨师 饭店 食堂 家庭 我们自己的感觉与知识 对盐特殊敏感的人群 增加盐的摄入特别容易升高血压 限制盐的摄入对血压控制特别明显 不太容易识别 寻找盐敏感人群 有高血压家族史 慢性肾脏病 糖尿病 ５０岁以上者 超重或肥胖者 终止高血压膳食:DASH 丰富的水果、蔬菜、低脂奶类和低脂肪、低胆固醇、低盐 低盐DASH膳食使高血压患者血压下降11.4/5.5 mmHg 而正常人只下降3.5/2.1 Source: Appel et al. N Engl J Med 1997;336:1117. DASH饮食计划参见/health/public/heart/hbp/dash 精打细算减盐行动 Food (CCHS 2004 data) % Pizza, sandwiches, subs, burgers, hot dogs* 19.1 Soups 7.4 Pasta 5.7 Liquid milk products 4.0 Poultry and poultry dishes 3.8 Potatoes 3.4 Cheese 3.2 Cereals 3.0 控盐小技巧 买新鲜的标明没有额外添加盐的食物 吃新鲜的而不是罐头或加工的肉类、鱼类 用无盐的调味品烹调 注意面条中的盐 每周减少2次饭店进餐 关注调味品中的盐 尽量不吃所有的罐