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序言,不同之处在哪里?

营养的重要性毋庸置疑,合理的膳食模式可以————

  1. 降低27%的高血压发生风险,对比不同年龄段高血压的发生风险,相当于年轻了10-20岁。【1、2】
  2. 降低13%的心血管疾病的发生风险,和用于的一级预防的阿司匹林,起到的效果相当。【3、4】
  3. 降低20%的直肠癌发生风险,33%的乳腺癌发生风险,相当于从携带有癌症基因的患者到没有癌症基因的健康人之间的差距。【5、6、7】
  4. 降低20%的糖尿病发生风险,相当于让自己多了9年的寿命。【8】
  5. 调整后的饮食干预可以让超重人群体重下降8%~20%。【9】

但是对于普通人,涉及到饮食习惯的改变难上加难。因为————

  1. 知识储备差。对营养学的理念认知有所偏差,如认为应该通过节食减肥,认为多吃南瓜可以降血压等。
  2. 不相信营养学的手段。知识 = 体验 X 敏感度。获取营养信息的过程体验差,故不认可接受到的知识;抑或改变饮食给人带来的利益并不能短期内得到体现,即体验的敏感度差,无法敏感地察觉到身体的变化。如宣教者没有强的说服力,健康饮食不能带来明显的体力增加、气色变好的反应。
  3. 行动困难。如人际环境困难,别人认为你的健康饮食是吃糠咽菜;或是真实环境困难,如时间不充裕、操作过于繁琐等。

本书的目标受众为需要对用户营养干预的营养从业者,会综合营养学和认知科学原理,讲述如何进行营养处方的制定,从而解决现阶段营养处方制定过程中存在的依从性、有效性的问题。整本书内容较为专业,不建议提供给患者阅读,并且有明显的时效性,营养学发展迅速,如出现新的膳食调查方法(如尿检【10】等),请根据当下情况实时做出决断。

参考文献

  1. Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response Meta-analysis of prospective cohort stuties. BMJ, 2014, 349: g4490.
  2. Thomas W. Buford, Hypertension and Aging, Ageing Res Rev. 2016 Mar; 26: 96–111.
  3. Marín-Guerrero AC, et al. Association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants in Spain.Br J Nutr. 2015 Jan 28;113(2):343-9.
  4. USPSTF: Final Guidelines on Aspirin as CVD, Cancer Prevention. Medscape. April 11, 2016
  5. Magalhães B, Peleteiro B, Lunet N.Dietary patterns and colorectal cancer: systematic review and meta-analysis.Eur J Cancer Prev. 2012 Jan;21(1):15-23.
  6. Albuquerque RC, Baltar VT, Marchioni DM.Breast cancer and dietary patterns: a systematic review. Nutr Rev. 2014 Jan;72(1):1-17.
  7. Hermann Brenner, Colorectal cancer, The Lancet, 2014 April, Volume 383, No. 9927, p1490–1502
  8. Esposito K, Chiodini P, et al. Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies. Endocrine. 2014 Sep;47(1):107-16.
  9. Dennis T,Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults N Engl J Med 2011; 364:1218-1229
  10. Isabel Garcia-Perez, Joram M Posma, et al. Objective assessment of dietary patterns by use of metabolic phenotyping: a randomised, controlled, crossover trial. The Lancet Diabetes & Endocrinology, 2017; DOI: 10.1016/S2213-8587(16)30419-3

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