The leading cause of death among Chinese people is actually this! You need a "healthy diet model" that is more suitable for Chinese people

Recently, the "Guidelines for Blood Lipid Management in China (2023)" was officially released. Dyslipidemia often occurs silently. Many people already have high blood lipids but do not know it. Over a long period of time, it may lead to a variety of cardiovascular diseases. It is particularly important to prevent dyslipidemia in life, and people who already have high blood lipids should pay more attention to their diet. In this article, we will talk about the problem of high blood lipids, and finally tell you a healthy diet model proposed by Chinese scholars.

01

What is the current status of dyslipidemia in my country?

In recent decades, the blood lipid levels and the prevalence of dyslipidemia in the Chinese population have increased significantly, with the most obvious increase in hypercholesterolemia. The results of a national survey in 2018 showed that the total prevalence of dyslipidemia in adults aged ≥18 in China was 35.6%, equivalent to nearly 4 in 10 people suffering from dyslipidemia. Data from the "Report on the Nutrition and Chronic Disease Status of Chinese Residents 2020" showed that there are 200 million people with dyslipidemia and 100 million patients with hyperlipidemia in China. Moreover, patients with dyslipidemia are not limited to adults. The prevalence of hypercholesterolemia in children and adolescents is not low, and blood lipid levels are also showing an upward trend. Data show that the increase in serum cholesterol levels in the Chinese population is expected to lead to an increase of approximately 9.2 million cardiovascular events in China from 2010 to 2030.

02

What are the dangers of dyslipidemia?

While paying attention to the total cholesterol value, we should also pay more attention to whether the low-density lipoprotein cholesterol index is normal. People with dyslipidemia tend to have elevated levels of low-density lipoprotein cholesterol, which is also called "bad cholesterol". It is easy to form plaques on the walls of coronary arteries and other arteries, leading to stenosis of arterial blood vessels, which in turn leads to reduced blood flow. It is a pathogenic risk factor for atherosclerotic cardiovascular disease. Cardiovascular diseases mainly caused by atherosclerosis, such as ischemic heart disease and ischemic stroke, are the leading cause of death among urban and rural residents in China, accounting for more than 40% of the causes of death. Therefore, this means that if you suffer from high blood lipids, you will be more likely to get cardiovascular and cerebrovascular diseases, such as coronary heart disease and stroke, than normal people.

03

Chinese Heart Healthy Dietary Pattern (CHH)

Adjusting your diet is the key to preventing and controlling hyperlipidemia. In the past, we have always recommended that everyone refer to the Mediterranean diet and the DASH diet. These two dietary patterns are very beneficial for controlling blood pressure and heart health.

However, the dietary habits of Chinese residents are quite different from those of Westerners. Recently, Chinese scholars have proposed the Chinese Heart Healthy Diet (CHH) , which maximizes the universality and acceptability of the diet of Chinese residents. The "Guidelines for Blood Lipid Management in China (2023)" mentions that the Chinese Heart Healthy Diet is also recommended for blood lipid control.

In the study of the Chinese heart-healthy dietary pattern, a total of four different versions of the "Chinese heart-healthy diet" recipes were developed, including Shandong cuisine, Huaiyang cuisine, Cantonese cuisine, and Sichuan cuisine. A total of 265 subjects were included. The baseline systolic blood pressure level of these participants was 130~159mmHg, and their ages were 25~75 years old. After a 7-day running-in period, they were randomly divided into two groups: a control group and an experimental group (135 Chinese heart-healthy diets and 130 control diets) for a double-blind parallel controlled diet trial. The control group continued to eat their daily diet, and the experimental group ate a special heart-healthy diet. However, the participants in both groups did not know the allocation of the intervention. Although the nutrition of the two groups' diets was different, the menus were very similar. Such blind grouping greatly improved the reliability of the data. After one month of observation, the data showed that the systolic and diastolic blood pressures of the control group on a regular diet decreased by an average of 5.0 mmHg and 2.8 mmHg, respectively; the systolic and diastolic blood pressures of the experimental group on a CHH diet decreased by an average of 15.0 mmHg and 6.7 mmHg, respectively, and there was no significant difference in the blood pressure-lowering effects among different cuisines.

The changes brought about by the CHH diet can greatly reduce the risk of coronary heart disease, stroke, and heart disease.

04

How to eat?

China's heart-healthy dietary pattern not only conforms to the eating habits of Chinese residents, but also can effectively lower blood pressure and help control blood lipids.

With such a good diet pattern, how should we eat in life if we want to control both blood pressure and blood lipids?

1) Change cooking methods and reduce cooking oil intake

This can reduce the energy supply ratio of fat by 5% to 8%, and use more low-temperature cooking methods such as steaming, boiling and stewing, and less frying.

The amount of cooking oil should be controlled at 20-25g/day (a spoonful of soup contains about 10g of oil), and unsaturated fatty acids should be used instead of saturated fatty acids (lard, palm oil, coconut oil, etc.). In addition, whole milk can be replaced with skim milk.

2) Increase the intake of whole grains. Replace part of the refined rice and flour with whole grains, such as replacing part of the white rice and flour with 1/3 to 1/2 of oatmeal, corn, brown rice, quinoa, buckwheat, red beans and mung beans, etc. , which can not only increase the intake of B vitamins and minerals, but also increase the intake of dietary fiber. The energy supply ratio of carbohydrates increased by 0% to 5%; at the same time, the intake of dietary fiber increased by 2 times, from 11 grams/day to 30 grams/day, which can better meet the recommended intake.

3) Increase the intake of protein foods

Increase the intake of lean meat, beans and milk , which are also high-quality proteins with high absorption and utilization rates, and can increase protein energy intake by 3.5% to 5.5%.

When cooking, you should often pair it with foods such as beef, chicken, dried tofu, bean skin, and northern tofu. You can choose meat that is rich in n-3 fatty acids , such as salmon, mackerel, yellow croaker, etc.

4) Reduce salt and increase potassium

When cooking, you should use less salt, and you can add more onions, ginger, garlic and thirteen spices for seasoning, and add salt after cooking. You can also replace table salt with low-sodium, high-potassium salt. This can reduce the total sodium intake from nearly 6000 mg/day to 3000 mg/day, and increase the potassium intake from less than 1700 mg/day to 3700 mg/day.

5) Eat more foods high in magnesium

Vegetables, fruits, whole grains and nuts are rich in magnesium.

6) Increase calcium intake

Eat more dairy products, beans and other foods that can supplement calcium, and drink 300 to 500 ml of milk every day. If you have abnormal blood lipids, it is recommended to drink skimmed milk.

7) Do not drink alcohol

Drinking alcohol is an important factor that increases triglycerides. People with high triglycerides need to strictly limit their alcohol intake and it is best not to drink alcohol.

8) Avoid trans fatty acids

For example, cakes, small desserts, chocolate with cocoa butter substitutes, ice cream, milk tea, wafers, etc. Foods with ingredients containing margarine, margarine, non-dairy creamer, shortening, cocoa butter substitutes, creamer, margarine, etc., all mean that they contain trans fatty acids.

9) Lower dietary cholesterol

Although studies have shown that dietary cholesterol intake significantly affects serum cholesterol levels, the relationship between dietary cholesterol and cardiovascular events has not yet been determined due to the influence of multiple confounding factors.

But after all, elevated serum cholesterol increases the risk of atherosclerosis, so on the basis of recommending the Chinese heart-healthy dietary pattern, it is still recommended that people with dyslipidemia control their cholesterol intake, and the daily dietary cholesterol intake should be below 300 mg. What is the concept of 300 mg of cholesterol? The following table shows the amount of cholesterol corresponding to 100 grams of food for reference. In addition, if you want to control cholesterol, it is best not to eat foods such as animal offal and animal brains. Don't take dyslipidemia lightly, and be alert to small problems turning into big diseases. Eat a balanced diet, exercise regularly, and have regular physical examinations.

References:

[1] “Guidelines for Blood Lipid Management in China (2023)”

[2] Wang Y, Feng L, Zeng G, Zhu H, Sun J, Gao P, Yuan J, Lan X, Li S, Zhao Y, Chen X, Dong H, Chen S, Li Z, Zhu Y, Li M, Li China: Multicenter, Single-Blind, Randomized, Parallel Controlled Feeding Trial. Circulation. 2022 Jul 26;146(4):303-315. doi: 10.1161/CIRCULATIONAHA.122.059045. Epub 2022 Jul 11. PMID: 35861850; PMCID: PMC9311470.

[3] Yang Yuexin. Chinese Food Composition Table 6th Edition Volume 2[M]. Peking University Medical Press, 2018

Author: Xue Qingxin, member of Chinese Nutrition Society, registered nutrition technician, health manager, public nutritionist

Reviewer: Han Hongwei, Director and Researcher of Risk Communication Department, National Food Safety Risk Assessment Center