Iingcamango zokuthi ukutya okunamafutha aphantsi, okunjengezo zinconywe iminyaka emininzi ngurhulumente wase-US kunye ne-American Heart Association (AHA), ziyasebenza ekukhuselweni kwezifo ze- cardiovascular disease (atherosclerotic heart disease ). Kwiminyaka emininzi edluleyo, izifundo zonyango apho amanqatha okutya aphelelwe ngaphantsi kwama-25% eekhalori zansuku zonke ahlulekile ukubonisa inzuzo ye-cardiovascular.
Kwiminyaka embalwa edlulileyo, i-AHA yancinci iyancipha iincophiso zayo zokutya eziphantsi.
Noko ke, kukho enye into engabonakaliyo kubungqina bokuba ukutya okunamafutha aphantsi akusebenzi kakuhle ekukhuseleni isifo senhliziyo-isonka se-Ornish. Ukutya kwe-Ornish (kunye nezidlo ezifanayo) azigcini nje kuphela ukucutha amanqatha okutya (kuya kuma-10% weekhalori zansuku zonke) kodwa zifuna nokuba nayiphi na ingcolileyo ifakwe kwimithombo yendalo. Kuzo zombini uncwadi lwezokwelapha kunye nokushicilela okuthandwayo, ukutya kwe-Ornish kubanjwe njengento ebonakaliswe ngokufanelekileyo ekukhuseleni ukuqhubela phambili kwezifo ze- coronary disease (CAD) kunye nokuququzelela ukuphuculwa okwenziwe kumathambo e- coronary artery .
Ngaba oku kunjalo? Nangona i-AHA-yokutya okunqandekileyo kwintlobo ye-fat-stricted diet has failed to prevent the atherosclerosis, ingabe i-Ornish-type-restrictive diet type type works?
Isifundo se-Ornish
Zonke iincwadi, iiwebhsayithi, ukubonakala kweTV, iintetho, i-editorials, i-documentaries, njl., Ukuba konke ukuphumelela kokutya kwe-Ornish kunokulandelwa kwisilingo esisodwa sekliniki, i-Lifestyle Heart Trial, eyenziwa ngama-1980s naku-1990 ngoDkt. I-Oran Ornish kunye neqela lakhe kwi-California Pacific Medical Centre eSan Franciso.
Bhalise izigulane ezingama-48 (ezingama-45 zazo zazingamadoda) ezaziyazi i-CAD. Iingamashumi amabini anesibhozo zazingenamsebenzi kwiprogram ekhethekileyo yokuguqulwa kwezinto zokuphila ezibandakanya ukutya okunqongopheleyo, ukutya kokutya, kunye nokucima ukucima, ukucamngca nokulawulwa koxinzelelo, kunye neprogram yokuzilolonga .
Ezinye izigulane ezingama-20, iqela lokulawula, alizange lifumane le nkqubo yokuphatha impilo enzulu. Ngethuba lexesha elilandelelweyo lokulandela iminyaka emi-5, izigulane kwiqela lokufunda zazibona zimbalwa iziganeko zenhliziyo kunezo zisegqeba lokulawula, kwaye zine-3% yokunciphisa ubukhulu bemigangatho yamatriyali yamaronary (xa kuthelekiswa nokunyuka kweeplates kwiqela lolawulo).
Kuyinto ephazamisayo encinci ukucinga ukuba umbuso wase-Ornish wakhiwe kule sifundo esincinci esisodwa. Kwelinye into, kwakukho ukuphuma okukhulu kwezigulane ngexesha lokufunda, kwaye ezi gulane zazingabandakanywa kwi-analysis. Ukuphuma kweyona nto ibaluleke ngakumbi kwizifundo ezincinci ukususela ekulahlekeni kwedatha kunokuchaphazela kakhulu iziphumo. Ubukhulu obuncinci besifundo buye kwavelisa ukungalingani kokuqala phakathi kwamaqela amabini. Ngokomzekelo, iqela lokulawula lalinomlinganiselo ophezulu we-cholesterol kunye ne- LDL ye-cholesterol imilinganiselo kwaye yayimdala kwaye iluncinci kuneqela lonyango. Kwakhona, ezi ntlobo zeengxaki ziqhelekileyo kwizilingo ezincinci zekliniki, kwaye zidala ubunzima obuyiyo ekuchazeni ukungafani kwiziphumo phakathi kwamaqela.
Okubaluleke ngakumbi, imbono yokuba ukutya kwe-Ornish kubangela ukuguqulwa kwe-atherosclerosis kunzima.
Ukuthelekisa iziphumo ezivela kwii- angiogram ezi-2-D ezahlukahlukeneyo ezenziwe ngamaxesha ahlukeneyo (njengokuba zenziwe kulolu cwaningo) zixhamle ngokugqithiseleyo ngephutha ekubeni ukungafani kangako kwiimbalo zeemifanekiso ezirekhodiweyo kunokuvelisa ulwahluko omkhulu ekubalweni kobukhulu beplate. Nangona ukuba imilinganiselo enjalo yayichanekile-kwaye ingabikho ngokuchanekileyo-ukujonga ngokuchanekileyo ukuguqulwa kwe-3% kwisikhululo se-plaque ayikwazi ukufezwa nayiphi na iqondo lokuzithemba nge-2-D engiography. Lo mdawulo awuyiyo mpazamo yabaphandi-iindlela ezingcono ezingekhoyo ngaloo mihla. (Ziyabakho namhlanje, ukuba isifundo se-Ornish siphindwe kwakhona.) Kodwa le mingcipheko ibaluleke kakhulu kwaye ibiza ngokuba ngumbuzo omkhulu amanqaku amaninzi awenziwe ngabacebisi ukuba ukutya kwe-Ornish kuguqula i-atherosclerosis.
Ukunciphisa okunjalo kwendlela yokwenza kube nzima kakhulu ukufundisisa okunje, ukuze kulandelwe ukushicilelwa namhlanje kwiphephancwadi yezobugcisa ezihlaziyiweyo.
Ekugqibeleni, nangona iziphumo ezichazwe kwisifundo se-Ornish ziphendule ukuba zichanekile, akunakwenzeka ukuba kukho nayiphi na le nzuzo kwi-Ornish yokutya. Oku kungenxa yokuba ezinye iindlela ezintathu zokungenelela ezisetyenziselwa iqela lokufunda (ukuyeka ukutshaya, ukulawula uxinzelelo, nokuzivocavoca rhoqo) ziyaziwa zonke ukuphucula iziphumo zengqondo kwizigulane ezine-CAD. Iziphumo eziphucukileyo ezibonwe kwiklasi yokonyango zichazwa ngamanye amatsha angenelelo; nayiphi na inzuzo evela kwi-Ornish yokutya ayikwazi ukunyanzelwa kulolu vavanyo.
Akukho nto inokuthi inkqubo yokulawulwa kwempilo yintlonelo yinto ebalulekileyo kwizigulane ezine-CAD, kunye nokufundwa kwe-Ornish (okokuqala, emva koko konke, kubizwa ngokuba yi-Lifestyle Heart Trial, kwaye kungekhona i-Ornish Triet Trial). Kodwa ngokubhekiselele ekuhlulekeni ngokubanzi kwezidlo eziphantsi kweetyule ukuphucula iziphumo zentliziyo kwezinye iingcaphephe, kukho ukungathandabuzeki okukhoyo malunga nokuba inzuzo enkulu yendima yesondlo yolu pho nonongo ibe negalelo kwiziphumo ezilungileyo. Uvavanyo olulungileyo lwezonyango luya kufuneka ukuba uphendule lo mbuzo.
Ngaphantsi
Ngokusekelwe kwiziphumo zovavanyo lwe-Ornish-ityala elincinci elincinci apho zonke izibango ezidumileyo malunga nokutya kwe-Ornish kusekelwe-ingcamango yokuba ukutya okutya okutya okutya okutya okuncinci kwe-CAD kufuneka kuthathwa njengengcamango ekhangayo. Kodwa konke oko-kungumzekelo we-hypothesis kwaye awukho ubungqina obuqinisekisiweyo. Uphando olutsha luya ku funeka luyilwe ukuze lubone ukuba i-hypothesis yinyani.
Yaye ukuba uya kulandela ukutya kwe-Ornish-type, qaphela loo oli yezityalo .
> Imithombo:
Ornish D, iSherberz L, uBillings J, et al. Ukuguquka okunzulu kwendlela yokuphila yokuguqulwa kwesifo sengqondo senhliziyo. JAMA 1998; 280: 2001-2007.