Umqondo wokuthi ukudla okunamafutha aphansi, okufana nalawo okunconywa iminyaka eminingi kangaka nguhulumeni wase-US kanye ne-American Heart Association (AHA), kusebenza kahle ekuvimbeleni izifo ze-atherosclerotic ze-cardiovascular disease manje sekuvame ukuhlukaniswa. Emashumini ambalwa adlule, izifundo zokwelapha lapho amafutha okudla ahlala ngaphansi kwamaphesenti angaba ngu-25% wekhalori yansuku zonke ahlulekile ukukhombisa inzuzo yomzimba.
Eminyakeni embalwa eyedlule, i-AHA yanciphisa ukusikisela kokudla okunamafutha aphansi.
Kodwa-ke, kukhona okuhlukile kokufakazela ukuthi ukudla okunamafutha aphansi akusebenzi kahle ekuvimbeleni isifo senhliziyo-ukudla oku-Ornish. Ukudla oku-Ornish (kanye nokudla okufanayo) akugcini nje ukuvimbela amanoni okudla kakhulu (kuya ezingaphansi kuka-10% zamakhalori wansuku zonke) kodwa futhi udinga noma yikuphi amafutha atshisiwe avela emithonjeni kuphela. Kuzo zombili izincwadi zezokwelapha kanye nabezindaba ezidumile, ukudla kwe-Ornish kubonakala sengathi sekuye kwafakazelwa ukuthi kuqinisekiswe ukuqhubekela phambili kwe- coronary artery disease (CAD) ngisho nokuthuthukisa ukuthuthukiswa kwangempela kwamakhemikhali e- coronary .
Ingabe lokhu kuyiqiniso? Naphezu kokuthi ukudla okulinganiselwe kwe-AHA-style fat has failed ukuvimbela ukuphefumula kwe-atherosclerosis, ingabe umsebenzi wokudla u-Ornish-restrictive usebenza?
Isifundo se-Ornish
Zonke izincwadi, amawebhusayithi, ukubukeka kwe-TV, izinkulumo, abahleli, amadokhumenti, njll, ukuthi yonke indlela yokudla kwe-Ornish ingalandelwa emuva kwesilingo esisodwa semitholampilo, i-Lifestyle Heart Trial, eyenziwa ngawo-1980 no-1990 nguDkt. UDean Ornish neqembu lakhe eCalifornia Pacific Medical Centre eSan Franciso.
Babhalise iziguli ezingu-48 (45 zazo zazingamadoda) ezaziwa i-CAD. Amashumi ayisishiyagalombili nesishiyagalolunye ayengeniswa ohlelweni oluthile lwezinguquko ezinzulu zokuphila ezibandakanya ukudla okunomthelela kakhulu, ukudla okunomsoco we-Ornish, kanye nokuyeka ukubhema, ukuzindla nokuphathwa kokucindezeleka, kanye nohlelo lokuqeqesha .
Ezinye iziguli ezingu-20, iqembu lokulawula, azitholanga lolu hlelo olujulile lokuphatha indlela yokuphila. Phakathi nenkathi yokulandelela kweminyaka engu-5, iziguli eziseqenjini lokucwaninga zathola izenzakalo ezincane kakhulu zenhliziyo kunezo eziqenjini lokulawula, futhi zine-3% ukuguqulwa ngobukhulu be-plaon artery coronary (uma kuqhathaniswa nokwanda kwama-plaques eqenjini lokulawula).
Kuyinto ephazamisayo encane ukucabangela ukuthi umbuso wesi-Ornish wakhiwe kulesi sifundo esincane esisodwa. Okokuqala, kwakukhona ukwehla okukhulu kweziguli phakathi nalesi sifundo, futhi lezi ziguli kamuva zafakwa ngaphandle kokuhlaziywa. Ukuphuma kwezinto kubalulekile ikakhulukazi kwizifundo ezincane kusukela ukulahlekelwa kwedatha kungathinta kakhulu imiphumela. Ubukhulu obuncane bokucwaninga kwaveza futhi umehluko omkhulu wokuqala phakathi kwamaqembu amabili. Isibonelo, iqembu lokulawula lalingamaphesenti aphakeme kakhulu e-cholesterol kanye ne- LDL ye-cholesterol amanani futhi asebekhulile futhi alula kunamaqembu okwelashwa. Nakulokhu, lezi zinkinga zivame ukuhlolwa okuncane emitholampilo, futhi zakha izinkinga ezikhona ekuchazeni umehluko kwimiphumela phakathi kwamaqembu.
Okubaluleke nakakhulu, umqondo wokuthi ukudla oku-Ornish kubangela ukuguqulwa kwe-atherosclerosis kuyinkinga enkulu.
Uma kuqhathaniswa nemiphumela ehlukene yama-2-D angiograms okwenziwe ngezikhathi ezahlukene (njengokwenziwe kulolu cwaningo) idonswa kakhulu ngephutha kusukela ukungafani okuncane emagumbini ezithombe eziqoshiwe kungenza kube nokuhlukana okukhulu ekubalweni kobukhulu be-plaque. Ngisho noma izilinganiso ezinjalo ziqondile-futhi zikude kakhulu-zibona ngokunembile ukuguqulwa kwezingu-3% ngobukhulu be-plaque azikwazi ukufezwa nganoma yikuphi izinga lokuzethemba nge-2-D engiography. Lokhu kunciphisa akuyona iphutha labacwaningi-amasu angcono awazange abe khona ngalezo zinsuku. (Zikhona namuhla, uma isifundo se-Ornish siphindaphindiwe.) Kodwa lokhu kunciphisa kungabalulekile futhi kubeka umbuzo omkhulu ekumangaliseni okuvamile okwenziwa ngabagqugquzeli ukuthi ukudla oku-Ornish kuguqula ukuqina kwe-atherosclerosis.
Ukulinganiselwa okunjalo kwemikhuba kungenza kube nzima kakhulu ukutadisha okunjengalezi ngisho nokwamukelwa ukuze kushicilelwe namhlanje kumagazini wezokwelapha obuyekezwa kontanga.
Okokugcina, noma ngabe imiphumela ebikiwe yocwaningo lwase-Ornish iye yaba yinto enembile, akunakwenzeka ukufakazela ukuthi yikuphi kwalokhu kuzuza ikakhulukazi ekudleni kwe-Ornish. Lokhu kungenxa yokuthi ezinye izinyathelo ezintathu ezisebenzisana neqembu lokucwaninga (ukuyeka ukubhema, ukuphathwa kokucindezeleka nokuzivocavoca njalo) konke kuyaziwa ukuthuthukisa imiphumela yomzimba ezigulini ezine-CAD. Imiphumela ephuthukisiwe eyabonwa eqenjini lokwelapha ichazwa yizi ezinye izindlela ezintathu zokungenelela; noma yikuphi ukuzuza kokudla kwe-Ornish ngokwayo akukwazi ukufakwa kulolu cwaningo.
Akungabazeki ukuthi uhlelo lokuphatha impilo enobudlova luyinto ewusizo ezigulini ezine-CAD, nokucwaninga kwe-Ornish (okuyinto, ngemva kwalokho, okuthiwa i-Lifestyle Heart Trial, hhayi i-Ornish Diet Trial) ngokuqinisekile yayisebenzisa izinguquko zokuphila ezinonya. Kodwa ngokuyinhloko ngenxa yokuhluleka okujwayelekile kokudla okunamafutha okuphansi ukuthuthukisa imiphumela yomzimba kwezinye izifundo, ukungabaza okukhulu kukhona mayelana nokuthi inzuzo engakanani ingxenye yokudla yalolu cwaningo inikeze emiphumeleni emihle. Isivivinyo somtholampilo esakhelwe kahle siyodingeka ukuphendula lo mbuzo.
Okubalulekile
Ngokusekelwe emiphumeleni yocwaningo lwase-Ornish-isilingo esincane esingenalutho lapho zonke izidakamizwa ezidumile ngokuphathelene nokudla kwe-Ornish kusekelwe-umqondo wokuthi ukudla okunomsoco we-fat-fat okuthuthukisa i-CAD kufanele kubhekwe njengengqondo ethakazelisayo. Kodwa yilokho kuphela-i-hypothesis engavumelekanga hhayi iqiniso eliqinisekisiwe. Ucwaningo olusha luzodinga ukuklanywa ukuze lubone ukuthi ngabe i-hypothesis iqinisile.
Futhi uma ulandela ukudla oku-Ornish-type, qaphela ukuthi amafutha yemifino .
> Imithombo:
I-Ornish D, i- Scherwitz L, uBillings J, et al. Izinguquko ezinzulu zokuphila zokuguqulwa kwesifo senhliziyo ye-coronary Ukulandela ukulandela iminyaka emihlanu ye-Lifestyle Heart Trial. I-JAMA 1998; 280: 2001-2007.