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Between 1986 and 1992 in the United States, mortality due to coronary heart disease among white men 45 to 74 years of age decrea
Between 1986 and 1992 in the United States, mortality due to coronary heart disease among white men 45 to 74 years of age decrea
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2011-01-06
78
问题
Between 1986 and 1992 in the United States, mortality due to coronary heart disease among white men 45 to 74 years of age decreased by 26 percent, continuing a trend that began in the mid-1960s. Americans are thus doing something right. But did fish consumption help? This is where the Health Professionals Follow-Up(起作用) Study comes in.
The study deals with the intake(摄影) of n-3 fatty acids and fish. The researchers calculated the intake of fish for 44,895 male health professionals—most of them dentists—in 1986 and kept track of their health status for the next six years. Surprisingly, the intake of n-3 fatty acids or fish in 1986 was not related to the risk of subsequent coronary disease. The number of participants was much larger than in other studies, and the methods and data analysis were solid. Also, measurements of fatty acids in adipose tissue showed that the questionnaire reliably ranked respondents according to their intake of 3 fatty acids.
The researchers carefully spell out the limitations of the study. First, two thirds of the men had greatly increased their intake of fish over the 10 years before 1986. Some of those increases could have occurred. Shortly before the base-line investigation in 1986, because the inverse relation between fish consumption and mortality due to coronary heart disease was first reported in 1985. Thus, data on fish intake may not reflect long term habits, and changes in fish intake during follow-up could also have attenuated an association with coronary disease. The authors performed separate analyses including only men who reported no change in their fish intake and again found no effect. However, it is hard for people to recall whether they changed their diet several years ago.
Second, the fish intake of these educated men was high and was more comparable with that of Norwegians or Japanese than with intake in the U.S. men studied previously. The epidemiologic data suggest that any beneficial effect is obtained with one or two servings of fish per week and that more is not better. Moreover, previous studies of fish intake have shown an association with the rate of mortality due to coronary disease, rather than with the incidence of nonfatal coronaty disease or coronary surgery. When seen in that light, there is some agreement between the present study and previous reports, because the risk of death from coronariy heart disease was about 25 percent lower among men who ate at least some fish than among those who ate no fish at all.
A third limitation of the study was that some of the men studied may have begun to eat fish, or may have eaten more, because they thought that they were at increased risk of a heart attack;the men in the highest 20 percent of the study group in terms of their in-take of n-3 fatty acids more frequently reported a family history of coronary disease or a personal history of high cholesterol levels than men who ate less fish.
The Harvard investigators concluded that increasing fish intake beyond one or two servings per week is unlikely to reduce the risk of coronary events substantially in men who are initially free of coronary disease. This is a prudent conclusion, and it could be extended to fish-oil capsules, which provide n-3 fatty acids in much larger amounts than are commonly consumed in food.
The findings of the Health Professionals Follow-up Study should somewhat dampen enthusiasm for fish and fish oil as a panacea against coronary disease. A little fish may still do some good, but more fish is not necessarily better.
Several studies have proven that fish intake can lower the mortality rate due to coronary disease.
选项
A、Right
B、Wrong
C、Not mentioned
答案
B
解析
见第四段,“其次,这些受教育程度高的人食鱼量较接近挪威人或日本人,而远高于以前参与研究的美国人。流行病学资料提示,一周食鱼一至二次即可获得它所能提供的好处,但并非越多越好。此外,以前的研究显示鱼摄入量与冠心病所致的死亡率有关,而不是与非致死性冠心病及其手术的发生率有关。若从这个角度来看,该研究与以前的报道可算相符,因为摄入哪怕是少量鱼的那些人死于冠心病的危险性比完全不吃鱼的人低25%”。
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