10步改變預防或逆轉心臟病
2017-04-24 16:48:27 來源：
Dr Hyman, my father has heart disease, his father did too, and I’m obviously concerned about my own h
“Dr. Hyman, my father has heart disease, his father did too, and I’m obviously concerned about my own heart,” writes this week’s house call. “What can I do to prevent heart disease?”
“我的父親患有心臟病，他的父親也是這樣，顯然我應該非常關注自己的心臟狀況，醫生，我能做些什么來預防心臟病呢？”
Most importantly, please know while genetics contributes to some degree, many other factors completely within your control can contribute to or reverse heart disease.
非常重要的一點，雖然遺傳學在一定程度上對于心臟病的發生發展起作用，但許多其他因素完全可以幫助或逆轉心臟??！
Genetics loads the gun, but environment pulls the trigger. The way you eat, how much you exercise, how you manage stress, and your exposure to environmental toxins all contribute to things like high cholesterol, high blood pressure, high blood sugar, and of course, heart disease.
“遺傳基因使槍上膛，但環境扣動扳機”。你進食的方式，鍛煉的程度，如何管理壓力以及暴露于環境毒素的多少，都會對高膽固醇、高血壓、高血糖以及心臟病等有所“貢獻”。
The current way doctors treat heart disease is misguided because they treat the risk factors not the causes. To think we can treat heart disease by lowering cholesterol, lowering blood pressure and lowering blood sugar with medication is like mopping up the floor while the sink overflows.
目前醫生治療心臟病的方式存在誤導，因為他們并不認為一些危險因素是生病的原因。想象一下，我們通過降脂、降壓和降糖來治療心臟病，這就如同在水槽溢出時，只將地板擦干凈而已。
Instead, we need to ask what causes these risk factors like high blood pressure, high blood sugar or abnormal cholesterol in the first place. Spoiler alert: These are not medication deficiencies! We treat these problems with medication, but studies have increasingly shown that treating these risk factors has only little benefit, or none at all. Research shows changing your lifestyle can be a more powerful intervention to prevent heart disease than any medication.
相反的，我們應當先應對高血壓、高血糖或膽固醇異常等危險因素，這才是首要的。透露一下：造成這些癥狀絕不是因為缺乏某種藥物！ 我們向來用藥物解決這些問題，但越來越多的研究表明，干預這些危險因素得到的效果甚微，或基本沒有效果，然而，生活方式的改變卻是比任何藥物都更強大的心臟病干預措施。
The “EPIC” study published in the Archives of Internal Medicine studied how 23,000 people adhered to four simple behaviors: Not smoking, exercising 3.5 hours a week, eating a healthy diet and maintaining a healthy weight. Adhering to those four behaviors alone prevented 93 percent of diabetes, 81 percent of heart attacks, 50 percent of strokes, and 36 percent of all cancers.
發表在“內科學檔案”上的“EPIC”研究了23000人遵循四種簡單的行為：不吸煙，每周運動3.5小時，健康飲食，保持健康體重。結果表明，秉承這四種行為的個體阻止了93％的糖尿病，81％的心臟病發作，50％的中風和36％的癌癥的發生。
Likewise, the INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found changing lifestyle could prevent at least 90 percent of all heart disease.
同樣地，2004年在“柳葉刀”發表的“INTERHEART”研究報告，追蹤了52個國家中的3萬人，研究人員發現，改變生活方式可以預防90％的心臟病的發生。
Other research shows lifestyle intervention becomes more effective than almost any other traditional medical intervention to reduce cardiovascular disease, hypertension, heart failure, stroke, cancer,diabesity and deaths from all causes.
還有其他研究表明，對于減少心血管疾病、高血壓、心力衰竭、中風、癌癥、肥胖和所有原因的死亡，生活方式干預比幾乎任何其他傳統的醫療干預更為有效。
Your environment, in turn, changes gene expression, subsequently modulating inflammation, oxidative stress and metabolic dysfunction. These are the reasons we get sick and develop heart disease along with other problems.
環境反過來會改變基因表達，隨后調節炎癥、氧化應激和代謝功能障礙，這些正是我們發生心臟病及其他問題的真正原因所在。
That’s actually good news. Addressing and fixing the root causes benefits most chronic disease. These modifications will make you feel alive and healthy without the side effects of medication.
其實這是好消息——定位和解決根本原因有利于大多數慢性病，這些變化將會使您脫離藥物的副作用，健康的生活。
Occasionally, I will use medications if I feel a patient shows a strong genetic predisposition for heart disease or if significant heart disease already exists. Under those circumstances, I carefully weigh a medication’s risks and benefits.
偶然的情況下，如果我發現患者對心臟病有很強的遺傳傾向，或者心臟病已經存在，我會使用藥物，但一定會仔細權衡藥物的風險和益處。
At the same time, most patients can achieve the benefits of most medications through lifestyle changes.
同時，大多數患者通過生活方式的改變可以達到大多數藥物的好處。
Dr. David Jenkins from the University of Toronto compared treatment with statin drugs (the number one cholesterol medication) with a diet rich in viscous fiber, almonds, soy and plant sterols. Researchers in this study found that, while they created almost equal benefits, diet became more effective to lower inflammation and homocysteine (a risk marker for heart disease).
多倫多大學的David Jenkins博士比較了與他汀類藥物（干預膽固醇首選藥物）的治療方案，其中含有富含粘性纖維、杏仁、大豆和植物甾醇的飲食，這項研究的人員發現，雖然它們創造了幾乎相同的效益，但飲食更有效地降低了炎癥和同型半胱氨酸（心臟病的風險標記）。
I’ve, likewise, had patients lower their cholesterol simply by incorporating positive dietary and lifestyle changes.
同樣，我也是通過納入積極的飲食和生活方式的改變，使患者降低膽固醇。
Simply put, preventative medicine becomes the best form of medicine. These 10 simple modifications can go a long way to preventing or reversing heart disease.
簡單來說——預防成為了最好的藥物。 以下10項簡單的改變對于預防或逆轉心臟病非常的有效。
1. Eat a healthy diet. Increase healthy, whole foods rich in nutrients and phytonutrients (plant molecules). Aim for at least 8 to 10 servings of colorful fruits and vegetables every day. These foods are loaded with disease-fighting vitamins, minerals, fiber, antioxidants and anti-inflammatory molecules.
健康飲食。 增加健康、豐富的營養成分和植物營養素（植物分子）。 目標是每天至少8-10份彩色蔬果，這些食物含有對抗疾病的維生素、礦物質、纖維、抗氧化劑和抗炎分子。
2. Steady your blood sugar. Studies show blood sugar imbalances contribute to heart disease. Stabilize your blood sugar with protein, healthy fat and healthy carbohydrates at every meal. Never eat carbohydrates alone, and avoid processed sugars with carbohydrates..
穩定血糖。 研究表明血糖不平衡對心臟病的發作有促進作用。每一餐攝入蛋白質、健康的脂肪和健康的碳水化合物可以穩定血糖，不要單獨攝入碳水化合物，并避免精加工的碳水化合物。
3. Increase your fiber. Work your way up to 50 grams of fiber per day. High-fiber foods include vegetables, nuts, seeds and lower-sugar fruits like berries. If that becomes a challenge, try a fiber supplement such as PGX (Konjac fiber or glucomannan).
增加纖維攝入。 每天至少50克，高纖維食品包括蔬菜、堅果、種子和低糖水果（如漿果）。如果有一定難度，可以嘗試使用纖維補充劑，如PGX（魔芋纖維或葡甘露聚糖）。
4. Avoid processed, junk foods. That includes sodas, juices and diet drinks, which adversely impact sugar and lipid metabolism. Researchshows liquid-sugar calories become the biggest contributor to obesity, diabetes and heart disease. Don’t be fooled that 100 percent fruit juice is healthy. Juices are essentially pure, liquid sugar because processing strips away the fruit’s fiber.
避免精加工的垃圾食品。包括蘇打水、果汁和飲料等，它們會對糖和脂質代謝產生不利影響。研究顯示液體糖的卡路里成為肥胖、糖尿病和心臟病最重要的因素。不要認為100％的果汁就是健康的，果汁基本上是純的液體糖，水果的纖維素已經被加工去除了。
5. Increase omega-3 fatty acids. Eat anti-inflammatory foods like cold-water fish including salmon, sardines and herring, as well as flaxseeds and even seaweed. Healthy fat actually benefits your heart by improving your overall cholesterol profile. It also lowers the small, dangerous LDL particles that contribute to heart disease by converting them into light, fluffy, safe LDL particles.
增加攝入ω-3脂肪酸。吃抗炎食物，比如冷水魚（包括鮭魚、沙丁魚和鯡魚），以及亞麻籽甚至海藻。 健康的脂肪通過改善您的整體膽固醇狀況有益于心臟，還通過將它們變成輕質、蓬松、安全的低密度脂蛋白顆粒來降低可以導致心臟病的小而危險的低密度脂蛋白顆粒。
6. Eliminate ALL hydrogenated fat. Hydrogenated fat lurks in margarine, shortening, processed oils and many baked goods and processed foods like cookies and crackers. Even when the label states “no trans fats,” the word “hydrogenated” indicates that the product contains trans fat in one or more of the ingredients. Use healthy oils instead like coconut oil (rich in medium-chain triglycerides or MCTs), extra-virgin, organic, cold-pressed, olive oil, organic sesame oil, and other nut oils.
消除所有氫化脂肪。 氫化脂肪潛伏在人造黃油、起酥油、加工油和許多烘焙食品和加工食品中（如曲奇和威化）。 即使標簽顯示“無反式脂肪”，“氫化”一詞表示產品在一種或多種成分中含有反式脂肪。建議您使用健康油代替椰子油（富含中鏈甘油三酸酯或MCT），特級、有機、冷壓橄欖油，有機芝麻油或其他堅果油。
7. Avoid or reduce alcohol intake. Alcohol can raise triglycerides, contribute to fatty liver and create sugar imbalances. Reducing or eliminating alcohol intake lowers inflammation, which contributes to heart disease and nearly every other chronic disease.
避免或減少酒精攝入量。 酒精可以提高甘油三酯，有助于形成脂肪肝，并造成糖分失衡。避免或減少酒精攝入可以降低炎癥，炎癥可以引發心臟病和幾乎所有其他慢性疾病。
8. Take quality supplements. Combined with a healthy diet and exercise program, supplements can dramatically improve cardiovascular health. Take a good multi-vitamin/mineral along with a purified fish oil supplement that contains 1000 to 2000 milligrams a day of EPA/DHA. (You might need higher doses if you have low HDL and high triglycerides.) I also recommend a fiber supplement such as PGX (Konjac fiber or gluccomanan) to lower cholesterol and balance blood sugar levels.
使用優質補充劑。 結合健康的飲食和運動計劃，補充劑可以顯著改善心血管健康。服用多種維生素、礦物質以及每天含有1000至2000毫克EPA / DHA的純化魚油補充劑，如果HDL和甘油三酯高，可能需要更高的劑量。我還建議使用纖維補充劑，如PGX（魔芋纖維或葡萄糖聚糖）來降低膽固醇并平衡血糖水平。
9. Get out and move! Research shows 30 to 45 minutes of cardiovascularexercise at least five times a week can benefit your heart. After all, your heart is a muscle, and muscles need exercise. If you feel stronger and more capable, high-intensity interval training (also called burst training) and strength training help build muscle, reduce body fat composition and maintain strong bones.
加強運動。研究顯示，每周至少5次，每次35-45分鐘的運動，可以使心臟功能受益。 畢竟，你的心臟是肌肉組成的，肌肉需要運動。如果你感覺強壯了，能力加強了，可以進行高強度間歇訓練（也稱爆發訓練）和力量訓練，有助于建立肌肉，減少身體脂肪組成并保持強壯的骨骼。
10. Manage stress levels. Stress alone can cause a heart attack. Sadly, chronic stress often triggers a cascade of events that cause that final, fatal heart attack. Among its problems, stress increases inflammation, raises your cholesterol and blood sugar, increases blood pressure and even makes your blood more likely to clot. Find your pause button to manage stress and relax. Yoga, Tai Chi, meditation, breathing techniques and guided imagery can lower stress.
壓力管理。 單獨壓力就可導致心臟病發作?？杀氖?，慢性壓力通常會在引發一系列事件之后，導致最后致命的心臟病發作。其中，壓力會增加炎癥，增加膽固醇和血糖，增加血壓，甚至使血液凝血。找到您自己身體的“暫停鍵”來管理壓力并放松。瑜伽、太極、冥想、呼吸技巧和引導影像都可以降低壓力。
“我的父親患有心臟病，他的父親也是這樣，顯然我應該非常關注自己的心臟狀況，醫生，我能做些什么來預防心臟病呢？”
Most importantly, please know while genetics contributes to some degree, many other factors completely within your control can contribute to or reverse heart disease.
非常重要的一點，雖然遺傳學在一定程度上對于心臟病的發生發展起作用，但許多其他因素完全可以幫助或逆轉心臟??！
Genetics loads the gun, but environment pulls the trigger. The way you eat, how much you exercise, how you manage stress, and your exposure to environmental toxins all contribute to things like high cholesterol, high blood pressure, high blood sugar, and of course, heart disease.
“遺傳基因使槍上膛，但環境扣動扳機”。你進食的方式，鍛煉的程度，如何管理壓力以及暴露于環境毒素的多少，都會對高膽固醇、高血壓、高血糖以及心臟病等有所“貢獻”。
The current way doctors treat heart disease is misguided because they treat the risk factors not the causes. To think we can treat heart disease by lowering cholesterol, lowering blood pressure and lowering blood sugar with medication is like mopping up the floor while the sink overflows.
目前醫生治療心臟病的方式存在誤導，因為他們并不認為一些危險因素是生病的原因。想象一下，我們通過降脂、降壓和降糖來治療心臟病，這就如同在水槽溢出時，只將地板擦干凈而已。
Instead, we need to ask what causes these risk factors like high blood pressure, high blood sugar or abnormal cholesterol in the first place. Spoiler alert: These are not medication deficiencies! We treat these problems with medication, but studies have increasingly shown that treating these risk factors has only little benefit, or none at all. Research shows changing your lifestyle can be a more powerful intervention to prevent heart disease than any medication.
相反的，我們應當先應對高血壓、高血糖或膽固醇異常等危險因素，這才是首要的。透露一下：造成這些癥狀絕不是因為缺乏某種藥物！ 我們向來用藥物解決這些問題，但越來越多的研究表明，干預這些危險因素得到的效果甚微，或基本沒有效果，然而，生活方式的改變卻是比任何藥物都更強大的心臟病干預措施。
The “EPIC” study published in the Archives of Internal Medicine studied how 23,000 people adhered to four simple behaviors: Not smoking, exercising 3.5 hours a week, eating a healthy diet and maintaining a healthy weight. Adhering to those four behaviors alone prevented 93 percent of diabetes, 81 percent of heart attacks, 50 percent of strokes, and 36 percent of all cancers.
發表在“內科學檔案”上的“EPIC”研究了23000人遵循四種簡單的行為：不吸煙，每周運動3.5小時，健康飲食，保持健康體重。結果表明，秉承這四種行為的個體阻止了93％的糖尿病，81％的心臟病發作，50％的中風和36％的癌癥的發生。
Likewise, the INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found changing lifestyle could prevent at least 90 percent of all heart disease.
同樣地，2004年在“柳葉刀”發表的“INTERHEART”研究報告，追蹤了52個國家中的3萬人，研究人員發現，改變生活方式可以預防90％的心臟病的發生。
Other research shows lifestyle intervention becomes more effective than almost any other traditional medical intervention to reduce cardiovascular disease, hypertension, heart failure, stroke, cancer,diabesity and deaths from all causes.
還有其他研究表明，對于減少心血管疾病、高血壓、心力衰竭、中風、癌癥、肥胖和所有原因的死亡，生活方式干預比幾乎任何其他傳統的醫療干預更為有效。
Your environment, in turn, changes gene expression, subsequently modulating inflammation, oxidative stress and metabolic dysfunction. These are the reasons we get sick and develop heart disease along with other problems.
環境反過來會改變基因表達，隨后調節炎癥、氧化應激和代謝功能障礙，這些正是我們發生心臟病及其他問題的真正原因所在。
That’s actually good news. Addressing and fixing the root causes benefits most chronic disease. These modifications will make you feel alive and healthy without the side effects of medication.
其實這是好消息——定位和解決根本原因有利于大多數慢性病，這些變化將會使您脫離藥物的副作用，健康的生活。
Occasionally, I will use medications if I feel a patient shows a strong genetic predisposition for heart disease or if significant heart disease already exists. Under those circumstances, I carefully weigh a medication’s risks and benefits.
偶然的情況下，如果我發現患者對心臟病有很強的遺傳傾向，或者心臟病已經存在，我會使用藥物，但一定會仔細權衡藥物的風險和益處。
At the same time, most patients can achieve the benefits of most medications through lifestyle changes.
同時，大多數患者通過生活方式的改變可以達到大多數藥物的好處。
Dr. David Jenkins from the University of Toronto compared treatment with statin drugs (the number one cholesterol medication) with a diet rich in viscous fiber, almonds, soy and plant sterols. Researchers in this study found that, while they created almost equal benefits, diet became more effective to lower inflammation and homocysteine (a risk marker for heart disease).
多倫多大學的David Jenkins博士比較了與他汀類藥物（干預膽固醇首選藥物）的治療方案，其中含有富含粘性纖維、杏仁、大豆和植物甾醇的飲食，這項研究的人員發現，雖然它們創造了幾乎相同的效益，但飲食更有效地降低了炎癥和同型半胱氨酸（心臟病的風險標記）。
I’ve, likewise, had patients lower their cholesterol simply by incorporating positive dietary and lifestyle changes.
同樣，我也是通過納入積極的飲食和生活方式的改變，使患者降低膽固醇。
Simply put, preventative medicine becomes the best form of medicine. These 10 simple modifications can go a long way to preventing or reversing heart disease.
簡單來說——預防成為了最好的藥物。 以下10項簡單的改變對于預防或逆轉心臟病非常的有效。
1. Eat a healthy diet. Increase healthy, whole foods rich in nutrients and phytonutrients (plant molecules). Aim for at least 8 to 10 servings of colorful fruits and vegetables every day. These foods are loaded with disease-fighting vitamins, minerals, fiber, antioxidants and anti-inflammatory molecules.
健康飲食。 增加健康、豐富的營養成分和植物營養素（植物分子）。 目標是每天至少8-10份彩色蔬果，這些食物含有對抗疾病的維生素、礦物質、纖維、抗氧化劑和抗炎分子。
2. Steady your blood sugar. Studies show blood sugar imbalances contribute to heart disease. Stabilize your blood sugar with protein, healthy fat and healthy carbohydrates at every meal. Never eat carbohydrates alone, and avoid processed sugars with carbohydrates..
穩定血糖。 研究表明血糖不平衡對心臟病的發作有促進作用。每一餐攝入蛋白質、健康的脂肪和健康的碳水化合物可以穩定血糖，不要單獨攝入碳水化合物，并避免精加工的碳水化合物。
3. Increase your fiber. Work your way up to 50 grams of fiber per day. High-fiber foods include vegetables, nuts, seeds and lower-sugar fruits like berries. If that becomes a challenge, try a fiber supplement such as PGX (Konjac fiber or glucomannan).
增加纖維攝入。 每天至少50克，高纖維食品包括蔬菜、堅果、種子和低糖水果（如漿果）。如果有一定難度，可以嘗試使用纖維補充劑，如PGX（魔芋纖維或葡甘露聚糖）。
4. Avoid processed, junk foods. That includes sodas, juices and diet drinks, which adversely impact sugar and lipid metabolism. Researchshows liquid-sugar calories become the biggest contributor to obesity, diabetes and heart disease. Don’t be fooled that 100 percent fruit juice is healthy. Juices are essentially pure, liquid sugar because processing strips away the fruit’s fiber.
避免精加工的垃圾食品。包括蘇打水、果汁和飲料等，它們會對糖和脂質代謝產生不利影響。研究顯示液體糖的卡路里成為肥胖、糖尿病和心臟病最重要的因素。不要認為100％的果汁就是健康的，果汁基本上是純的液體糖，水果的纖維素已經被加工去除了。
5. Increase omega-3 fatty acids. Eat anti-inflammatory foods like cold-water fish including salmon, sardines and herring, as well as flaxseeds and even seaweed. Healthy fat actually benefits your heart by improving your overall cholesterol profile. It also lowers the small, dangerous LDL particles that contribute to heart disease by converting them into light, fluffy, safe LDL particles.
增加攝入ω-3脂肪酸。吃抗炎食物，比如冷水魚（包括鮭魚、沙丁魚和鯡魚），以及亞麻籽甚至海藻。 健康的脂肪通過改善您的整體膽固醇狀況有益于心臟，還通過將它們變成輕質、蓬松、安全的低密度脂蛋白顆粒來降低可以導致心臟病的小而危險的低密度脂蛋白顆粒。
6. Eliminate ALL hydrogenated fat. Hydrogenated fat lurks in margarine, shortening, processed oils and many baked goods and processed foods like cookies and crackers. Even when the label states “no trans fats,” the word “hydrogenated” indicates that the product contains trans fat in one or more of the ingredients. Use healthy oils instead like coconut oil (rich in medium-chain triglycerides or MCTs), extra-virgin, organic, cold-pressed, olive oil, organic sesame oil, and other nut oils.
消除所有氫化脂肪。 氫化脂肪潛伏在人造黃油、起酥油、加工油和許多烘焙食品和加工食品中（如曲奇和威化）。 即使標簽顯示“無反式脂肪”，“氫化”一詞表示產品在一種或多種成分中含有反式脂肪。建議您使用健康油代替椰子油（富含中鏈甘油三酸酯或MCT），特級、有機、冷壓橄欖油，有機芝麻油或其他堅果油。
7. Avoid or reduce alcohol intake. Alcohol can raise triglycerides, contribute to fatty liver and create sugar imbalances. Reducing or eliminating alcohol intake lowers inflammation, which contributes to heart disease and nearly every other chronic disease.
避免或減少酒精攝入量。 酒精可以提高甘油三酯，有助于形成脂肪肝，并造成糖分失衡。避免或減少酒精攝入可以降低炎癥，炎癥可以引發心臟病和幾乎所有其他慢性疾病。
8. Take quality supplements. Combined with a healthy diet and exercise program, supplements can dramatically improve cardiovascular health. Take a good multi-vitamin/mineral along with a purified fish oil supplement that contains 1000 to 2000 milligrams a day of EPA/DHA. (You might need higher doses if you have low HDL and high triglycerides.) I also recommend a fiber supplement such as PGX (Konjac fiber or gluccomanan) to lower cholesterol and balance blood sugar levels.
使用優質補充劑。 結合健康的飲食和運動計劃，補充劑可以顯著改善心血管健康。服用多種維生素、礦物質以及每天含有1000至2000毫克EPA / DHA的純化魚油補充劑，如果HDL和甘油三酯高，可能需要更高的劑量。我還建議使用纖維補充劑，如PGX（魔芋纖維或葡萄糖聚糖）來降低膽固醇并平衡血糖水平。
9. Get out and move! Research shows 30 to 45 minutes of cardiovascularexercise at least five times a week can benefit your heart. After all, your heart is a muscle, and muscles need exercise. If you feel stronger and more capable, high-intensity interval training (also called burst training) and strength training help build muscle, reduce body fat composition and maintain strong bones.
加強運動。研究顯示，每周至少5次，每次35-45分鐘的運動，可以使心臟功能受益。 畢竟，你的心臟是肌肉組成的，肌肉需要運動。如果你感覺強壯了，能力加強了，可以進行高強度間歇訓練（也稱爆發訓練）和力量訓練，有助于建立肌肉，減少身體脂肪組成并保持強壯的骨骼。
10. Manage stress levels. Stress alone can cause a heart attack. Sadly, chronic stress often triggers a cascade of events that cause that final, fatal heart attack. Among its problems, stress increases inflammation, raises your cholesterol and blood sugar, increases blood pressure and even makes your blood more likely to clot. Find your pause button to manage stress and relax. Yoga, Tai Chi, meditation, breathing techniques and guided imagery can lower stress.
壓力管理。 單獨壓力就可導致心臟病發作?？杀氖?，慢性壓力通常會在引發一系列事件之后，導致最后致命的心臟病發作。其中，壓力會增加炎癥，增加膽固醇和血糖，增加血壓，甚至使血液凝血。找到您自己身體的“暫停鍵”來管理壓力并放松。瑜伽、太極、冥想、呼吸技巧和引導影像都可以降低壓力。
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