地中海饮食能延寿

Mediterranean Diet Cuts Heart Disease Risk, Study Finds
地中海饮食能延寿

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found.

一项新的大型、严谨的研究发现，如果高危人群能够改变饮食习惯，接受富含食用橄榄油、坚果、豆类、鱼类、水果和蔬菜的饮食结构，甚至在就餐时喝葡萄酒，那么，约30%的心脏病发作、中风及心脏病导致的死亡是可以避免的。

The findings, published on The New England Journal of Medicine’s Web site on Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

这些发现基于一项旨在衡量饮食对心脏病发病风险影响的试验，是在此课题上开展的首次大型临床试验。周一，《新英格兰医学杂志》(The New England Journal of Medicine)的网站上刊发了结果。地中海饮食结构的益处之大令专家们感到震惊。这项试验在进行了近五年后提前结束，因为结果是如此明显，继续进行下去则有违背行业原则的嫌疑。

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.

这种饮食对人大有益处，即便他们并未因此减轻体重，而且其中多数人已经在服用他汀类降脂药，或者高血压、糖尿病药物来降低他们的心脏病发病风险。

“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association. “And the really important thing — the coolest thing — is that they used very meaningful endpoints. They did not look at risk factors like cholesterol of hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

佛蒙特大学(University of Vermont)营养学教授、美国心脏协会(American Heart Association)女发言人瑞秋·约翰逊(Rachel Johnson)说，“真的令人赞叹，而且真正重要的、也是最棒的是，他们采用了非常有意义的终点指标。他们没有关注高血压病人的胆固醇含量或体重等风险因素，而是考察了心脏病发作、中风和死亡的发生。说到底，这才是最重要的。”

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.

在此之前，地中海饮食能够降低心脏病发病风险的证据很薄弱。大部分研究显示出，地中海国家的人民似乎患心脏病的几率比较低，但这种模式也可以归因于饮食以外的因素。

And some experts had been skeptical that the effect of diet could be detected, if it existed at all, because so many people are already taking powerful drugs to reduce heart disease risk, while other experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have a lot of calories.

一些专家曾一直质疑，即便这种饮食确实有益，是否能测定它的效果，也是问题，因为许多人已经在服用强效药来降低心脏病发病风险。同时，其他专家也不愿向那些已经有体重问题的人推荐这种饮食，因为食用油和坚果含有很高热量。

Heart disease experts said the study was a triumph because it showed that a diet was powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, or had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.

心脏病专家称，这项研究取得了重大的成功，因为它显示出一种饮食在降低心脏病风险方面的重要效果，而且其研究方法也是最为严谨的。科学家们在西班牙随机选取了7447人，让他们采用地中海饮食或低脂饮食，这些人要么超重、吸烟，要么患有糖尿病或有其他增加心脏病风险的因素。

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality borne out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.

克利夫兰医学中心(Cleveland Clinic Foundation)的心血管病学部主任史蒂文·E·尼森博士(Steven E. Nissen)说，还没有任何严谨的研究显示出低脂饮食的益处，而且病人也难以坚持这种饮食习惯——最新研究也证实了这一情况。

“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”

“现在，出现了这群人，他们在西班牙进行了一项大规模的研究。结果显示，人们可以采用由水果、蔬菜、橄榄油组成的均衡饮食，将心脏病风险降低30%，”他说。“人们可以真正地享受生活。”

The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there.

这项研究由巴塞罗那大学(University of Barcelona)的医学教授拉蒙·埃斯特鲁奇(Ramon Estruch)及其同事完成，经过了多年的策划。单靠饮食能否极大地改变心脏病的发病风险，为了找到回答这一问题的最佳方法，调查人员去世界各地寻求建议。他们数次拜访了哈佛大学公共卫生学院(Harvard School of Public Health)，咨询心血管疾病预防领域的教授弗兰克·M·萨克斯博士(Frank M. Sacks)的意见。

In the end, they decided to randomly assign subjects at high risk of heart disease to three groups. One would be given a low-fat diet and counseled on how to follow it. The other two groups would be counseled to follow a Mediterranean diet. At first the Mediterranean dieters got more intense support. They met regularly with dietitians while the low-fat group just got an initial visit to train them in how to adhere to the diet followed by a leaflet each year on the diet. Then the researchers decided to add more intensive counseling for them, too, but they still had difficulty staying with the diet.

最后，他们决定将受试的心脏病高危人群随机分成三组。一组进行低脂饮食，并接受如何遵循这种食谱的指导。另外两组则按指导遵循地中海饮食。起先，后两组受试者获得了更多的支持。他们经常与膳食专家会面，而第一组受试者仅在开始的时候与膳食专家会面，接受如何坚持低脂饮食的培训，之后每年拿到一本饮食手册。后来，研究人员决定也给他们增加更密集的咨询指导，但他们还是难以坚持低脂饮食。

One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was instructed to use at least four tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.

地中海饮食受试者中的第一组每周获得特级初榨橄榄油，要求每天摄入至少四餐匙。另一组受试者获得由胡桃、杏仁和榛子组成的混合坚果，要求每天摄入约一盎司（约合28克）。以胡桃为例，一盎司差不多是四分之一杯，用手抓则是一大把。这种饮食的主要构成还包括每天吃至少三次水果和至少两次蔬菜。受试者还每周吃至少三次鱼和至少三次豆类（包括蚕豆、豌豆和小扁豆）。他们用白肉代替饮食里的红肉，而习惯饮酒的人每周在就餐时至少会喝七杯葡萄酒。

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

研究人员鼓励他们避免吃商店出售的饼干、蛋糕和油酥点心，并限制奶制品和加工肉类的摄入量。

To assess compliance with the Mediterranean diet, researchers measured levels of a marker in urine of olive oil consumption — hydroxytyrosol — and a blood marker of nut consumption — alpha-linolenic acid.

为了评估受试者是否遵循了地中海饮食，研究人员测量了两项指标，一种是表明橄榄油食用量的一项尿液指标——羟基酪醇，另一种则是表明坚果食用量的血液指标——α-亚麻酸。

The participants stayed with the Mediterranean diet, the investigators reported. But those assigned to a low-fat diet did not lower their fat intake very much. So the study wound up comparing the usual modern diet, with its regular consumption of red meat, sodas and commercial baked goods, to a diet that shunned all that.

研究人员称，这些受试者都坚持了地中海饮食。但是，分到低脂饮食组的受试者并没有把他们的脂肪摄入量减少多少。因此，研究人员最后比较的是经常摄入红肉、碳酸饮料和烘培商品的普通现代饮食与避免以上所有摄入的地中海饮食。

Dr. Estruch said he thought the effect of the Mediterranean diet was because of the entire package, not just the olive oil or nuts. He did not expect, though, to see such a big effect so soon. “This is actually really surprising to us,” he said.

埃斯特鲁奇博士称，他认为地中海饮食的效果是由整套食谱带来的，而不光是因为橄榄油或坚果。不过，他之前并未预料到这么快就能取得这么好的效果。他说，“这其实真的让我们大吃一惊。”