The Korean Journal of Medicine

  • 제87권2호
  • /
  • Pages.131-135
  • /
  • 2014
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

심혈관 위험을 낮추기 위한 생활습관 관리

Lifestyle Management to Reduce Cardiovascular Risk

  • 박형욱 (전남대학교 의과대학 전남대학교병원 순환기내과)
  • Park, Hyung Wook (Division of Cardiovascular Medicine, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School)
  • 발행 : 2014.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

음식 저밀도 지단백 조절 야채, 과일, 전곡(whole grain), 저지방 유제품, 가금류, 생선, 콩류, 비열대성(non-tropical) 식물성 유지 및 견과류를 섭취하도록 권장하며 감미료, 설탕 함유 청량음료(sugar-sweetened beverage), 붉은 고기류(red meat) 섭취는 제한한다. 포화지방산으로부터 얻는 칼로리는 전체 칼로리의 5-6% 정도로 유지되도록 하며 포화지방산 섭취를 줄인다. 트렌스 지방으로 얻는 칼로리도 줄인다. 혈압 조절 야채, 과일, 전곡(whole grain), 저지방 유제품, 가금류, 생선, 콩류, 비열대성(non-tropical) 식물성 유지 및 견과류를 섭취하도록 권장하며 감미료, 설탕 함유 청량음료(sugar-sweetened beverage), 붉은 고기류(red meat) 섭취는 제한한다. 염분 섭취를 줄여 하루 염분을 2,400 mg 이상 섭취하지 않도록 한다. 1,500 mg 이하로 줄이면 혈압 감소 효과가 더 크다. 운동 지질 저밀도 지단백(LDL-C) 및 비고밀도 지단백(non-HDL-C)을 감소시키기 위하여 중-고강도(moderate-to-severe intensity) 유산소 운동을 1회 평균 40분, 주 3-4회 하도록 권장한다. 혈압 혈압을 낮추기 위하여도 같은 정도의 유산소 운동을 중-고강도(moderate-to-severe intensity)로 1회 평균 40분, 주 3-4회 하도록 권장한다.

A healthy lifestyle is important in the prevention and delayed progression of cardiovascular disease (CVD). The intent of this lifestyle management guideline review is to evaluate evidence describing particular dietary patterns, nutrient intake, and levels and types of physical activity associated with CVD risk. The recommendations of this article may be used in management of hypercholesterolemia and hypertension. The proposed guidelines emphasize the importance of dietary patterns rather than individual dietary components. Dietary patterns offer the opportunity to characterize the overall composition and quality of the eating behaviors of a population, such as a Mediterranean-style diet. Dietary sodium and potassium are particularly relevant in CVD due to their effects on blood pressure, while substantial epidemiologic evidence links higher levels of aerobic physical activity to lower rates of CVD and other chronic diseases such as Type 2 diabetes mellitus. This indicates that weight loss and maintenance are critical for prevention and control of CVD risk factors.

키워드

참고문헌

  1. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation 2014;129(25 Suppl 2):S76-99. https://doi.org/10.1161/01.cir.0000437740.48606.d1
  2. Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005-2008.
  3. Srinath Reddy K, Katan MB. Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutr 2004;7(1A):167-186.
  4. Diet, nutrition, and the prevention of chronic diseases: report of a WHO Study Group. World Health Organ Tech Rep Ser 1990;797:1-204.
  5. Gibbons GH, Shurin SB, Mensah GA, Lauer MS. Refocusing the agenda on cardiovascular guidelines: an announcement from the National Heart, Lung, and Blood Institute. J Am Coll Cardiol 2013;62:1396-1398. https://doi.org/10.1016/j.jacc.2013.08.003
  6. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63(25_PA). doi:10.1016/j.jacc.2013.11.002.
  7. Panagiotakos DB, Pitsavos C, Stefanadis C. Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 2006;16:559-568. https://doi.org/10.1016/j.numecd.2005.08.006
  8. Michalsen A, Lehmann N, Pithan C, et al. Mediterranean diet has no effect on markers of inflammation and metabolic risk factors in patients with coronary artery disease. Eur J Clin Nutr 2006;60:478-485. https://doi.org/10.1038/sj.ejcn.1602340
  9. Mozaffarian D, Clarke R. Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr 2009;63(Suppl 2):S22-33. https://doi.org/10.1038/sj.ejcn.1602976
  10. Tang JL, Armitage JM, Lancaster T, Silagy CA, Fowler GH, Neil HA. Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects. BMJ 1998;316:1213-1220.
  11. Wolever TM, Gibbs AL, Mehling C, et al. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr 2008;87:114-125.
  12. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure: DASH Collaborative Research Group. N Engl J Med 1997;336:1117-1124. https://doi.org/10.1056/NEJM199704173361601
  13. Obarzanek E, Sacks FM, Vollmer WM, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr 2001;74:80-89.
  14. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet: DASH-Sodium Collaborative Research Group. N Engl J Med 2001;344:3-10. https://doi.org/10.1056/NEJM200101043440101
  15. Bray GA, Vollmer WM, Sacks FM, et al. A further subgroup analysis of the effects of the DASH diet and three dietary sodium levels on blood pressure: results of the DASH-Sodium Trial. Am J Cardiol 2004;94:222-227. https://doi.org/10.1016/j.amjcard.2004.03.070
  16. Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE): TONE Collaborative Research Group. JAMA 1998;279:839-846. https://doi.org/10.1001/jama.279.11.839
  17. Tuomilehto J, Jousilahti P, Rastenyte D, et al. Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study. Lancet 2001;357:848-851. https://doi.org/10.1016/S0140-6736(00)04199-4
  18. Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I). Lancet 1998;351:781-785. https://doi.org/10.1016/S0140-6736(97)09092-2
  19. Fang J, Madhavan S, Alderman MH. Dietary potassium intake and stroke mortality. Stroke 2000;31:1532-1537. https://doi.org/10.1161/01.STR.31.7.1532
  20. Iso H, Stampfer MJ, Manson JE, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999;30:1772-1779. https://doi.org/10.1161/01.STR.30.9.1772
  21. Al-Delaimy WK, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Magnesium intake and risk of coronary heart disease among men. J Am Coll Nutr 2004;23:63-70. https://doi.org/10.1080/07315724.2004.10719344
  22. Ascherio A, Rimm EB, Hernán MA, et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation 1998;98:1198-1204. https://doi.org/10.1161/01.CIR.98.12.1198
  23. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization, 2010:1-60.
  24. Shiroma EJ, Lee IM. Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity. Circulation 2010;122:743-752. https://doi.org/10.1161/CIRCULATIONAHA.109.914721
  25. Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380:219-229. https://doi.org/10.1016/S0140-6736(12)61031-9