Åñòü ëè ñâÿçü ìåæäó ðèñêîì èíñóëüòà è ïèùåé,
áîãàòîé æèâîòíûìè æèðàìè è õîëåñòåðèíîì?
Ê. Ìîíàñòûðñêèé

Íîâîñòè íåäåëè
Êîììåíòèðóåò Êîíñòàíòèí Ìîíàñòûðñêèé
Íå ìîæåò áûòü...
Dec 7, 2003 — Èíñóëüò (stroke) — îñòðîå íàðóøåíèå ìîçãîâîãî êðîâîîáðàùåíèÿ — òðàãè÷åñêîå è áîëüøåé ÷àñòüþ ôàòàëüíîå çàáîëåâàíèå. Òðóäíî ñêàçàòü, ÷òî â òàêîì ñëó÷àå «ëó÷øå» — ïàðàëè÷, êîìà èëè ìîìåíòàëüíàÿ ñìåðòü. Òîëüêî â 2000 ãîäó â ÑØÀ îò èíñóëüòà ñêîí÷àëîñü îêîëî 283 000 ÷åëîâåê. Ïîñëå ðàêîâûõ è ñåðäå÷íûõ çàáîëåâàíèé, èíñóëüò — òðåòüÿ ïî ñ÷åòó ïðè÷èíà ñìåðòíîñòè â ÑØÀ:
"Stroke accounted for about 1 of every 14 deaths in the United States in 2000. About 50 percent of these deaths occurred out of hospital. Total mention mortality — about 283,000." (Heart Disease and Stroke Statistics — 2003 Update, page 16, American Heart Association.)
Àòåðîñêëåðîç ñîñóäîâ è èíñóëüò — ñîïóòñòâóþùèå ñîñòîÿíèÿ. «Most vascular injury to the brain is secondary to atherosclerosis or hypertension», — îäíîçíà÷íî óêàçàíî ïî ýòîìó ïîâîäó â The Merck Manual of Diagnosis and Therapy. Ê àòåðîñêëåðîçó ïðåæäå âñåãî ïðåäðàñïîëàãàþò âîçðàñò, êóðåíèå, íàðóøåíèÿ óãëåâîäíîãî îáìåíà (ñàõàðíûé äèàáåò, îæèðåíèå, ãèïåðèíñóëèíåìèÿ, ãèïåðòîíèÿ), ñòðåññ è íåêîòîðûå äðóãèå ôàêòîðû. Êðîìå òîãî, àêòèâíî ïðîïàãàíäèðóåòñÿ ãèïîòåçà î òîì, ÷òî äèåòà, áîãàòàÿ íàñûùåííûìè æèðàìè è õîëåñòåðèíîì óñóãóáëÿåò àòåðîñêëåðîç, à äèåòà, áîãàòàÿ ðàñòèòåëüíûìè ìàñëàìè, åãî ïðåäóïðåæäàåò. Íà îñíîâàíèè ýòîé ãèïîòåçû (îáðàòèòå âíèìàíèå: ïî ñåé äåíü ãèïîòåçû, à íå äîêàçàííîãî ôàêòà!), äåñÿòêè ìèëëèîíîâ àìåðèêàíöåâ ïðèíèìàþò ëåêàðñòâà äëÿ ïîíèæåíèÿ õîëåñòåðèíà è èçáåãàþò, êàê ïðîêàçû, æèâîòíûõ áåëêîâ è æèðîâ â ïèùå.
ß íåîäíîêðàòíî ïèñàë, ÷òî ýòà ãèïîòåçà áàçèðóåòñÿ íà ôàëüñèôèöèðîâàííûõ èññëåäîâàíèÿõ è ïðåäíàìåðåííîì îáìàíå âðà÷åé è íàñåëåíèÿ ñòðàõîâûìè êîìïàíèÿìè, ôàðìàöåâòè÷åñêèå ôèðìàìè, êëèíè÷åñêèìè ëàáîðàòîðèÿì, ïðîèçâîäèòåëè «çäîðîâûõ» ïðîäóêòîâ è ëîááèñòàìè — âñåìè òåìè, äëÿ êîãî ïàíèêà âîêðóã õîëåñòåðèíà ñòàëà çîëîòîé æèëîé. (Ýòîìó ïîñâÿùåí öèêë ñòàòåé «Õîëåñòåðèí — êàê õî÷ó, òàê âåð÷ó!»)
Ìíåíèå American Heart Association (è å¸ ôèëèàëà — American Stroke Association) ïî ýòîìó ïîâîäó îäíîçíà÷íû:
"…A high level of total cholesterol in the blood (240 mg/dL or higher) is a major risk factor for heart disease, which raises your risk of stroke."
Stroke Risk Factors, American Heart Association
Èìåííî íà îñíîâàíèè ýòîãî óòâåðæäåíèÿ àìåðèêàíöàì ðåêîìåíäóåòñÿ èçáåãàòü ïèùó, áîãàòóþ õîëåñòåðèíîì è íàñûùåííûìè æèðàìè — «êðàñíîå» ìÿñî, ñàëî, ÿéöà, ïðîäóêòû èç öåëüíîãî ìîëîêà, ñëèâêè, ñëèâî÷íîå ìàñëî è ò.ï. Îïðàâäàí ëè ýòîò çàïðåò? Îäíîçíà÷íî — íåò, ýòî ïîëíàÿ ÷óøü, íåïðàâäà! Íî îäíî äåëî, îñîáåííî äëÿ ñêåïòèêîâ, — àíàëèç è âûâîäû Ìîíàñòûðñêîãî, ñîâåðøåííî äðóãîå — ìíîãîëåòíèå èññëåäîâàíèÿ àìåðèêàíñêèõ ó÷åíûõ, äà åùå è èç ïðåñòèæíîãî Ãàðâàðäñêîãî óíèâåðñèòåòà (Department of Nutrition, Harvard School of Public Health, Boston, MA).
À âîò çà ïðàâäîé íàì ïðèäåòñÿ îòïðàâèòüñÿ çà ãðàíèöó, â òóìàííûé Àëüáèîí, êóäà òåïåðü, ïî ñòîïàì Ìàðêñà, Ëåíèíà è, ñ íåäàâíèõ âðåìåí, ã-íà Áåðåçîâñêîãî, ïðîòàïòûâàþò òðîïèíêó àìåðèêàíñêèå ó÷åíûå, ñåíñàöèîííûå èññëåäîâàíèÿ êîòîðûõ íå ñîîòâåòñòâóþò èíòåðåñàì àíòèõîëåñòåðèíîâîãî ëîááè è, ïîýòîìó èõ ðåçóëüòàòû íåâîçìîæíî îïóáëèêîâàòü â ïðåñòèæíûõ ìåäèöèíñêèõ æóðíàëàõ ÑØÀ.
Ñëàâà Áîãó, â Àíãëèè, ãäå ïîòðîõà è áèôøòåêñ — ïî-ïðåæíåìó ôóíäàìåíò íàöèîíàëüíîé äèåòû, ãäå ìîëî÷íèêè è ïîíûíå ðàçâîçÿò ïî óòðàì ïàðíîå ìîëîêî, ñìåòàíó è ñëèâêè â ñòåêëÿííûõ áóòûëêàõ, è ãäå äåíü íà÷èíàåòñÿ ñ ÿè÷íèöû íà áåêîíå — ïðàâäèâàÿ èíôîðìàöèÿ ïóáëèêóåòñÿ îõîòíî, îñîáåííî, åñëè ðå÷ü èäåò î êðàñíîì ìÿñå, æèðàõ è õîëåñòåðèíå…
È êàêàÿ æå íà ýòîò ðàç ïðàâäà âûïëûëà ïî òó ñòîðîíó Àòëàíòè÷åñêîãî îêåàíà â British Medical Journal (BMJ)? À âîò êàêàÿ: 14-ëåòíåå èññëåäîâàíèå íå ïðîñòî ìóæ÷èí, à 43 732 àìåðèêàíñêèõ ìåäèöèíñêèõ ðàáîòíèêîâ â âîçðàñòå îò 40 äî 75 ëåò, íå îáíàðóæèëî íèêàêîé âçàèìîñâÿçè ìåæäó ðèñêîì èíñóëüòà è óïîòðåáëåíèåì ïðîäóêòîâ, áîãàòûõ æèâîòíûìè æèðàìè è õîëåñòåðèíîì. Í-È-Ê-À-Ê-Î-É-!
Íå ñî÷òèòå çà òðóä ïîçíàêîìèòüñÿ ñ êðàòêèì ðåôåðàòîì (abstract). Êðàñíûì âûäåëåíû êëþ÷åâûå âûâîäû èññëåäîâàíèÿ:
Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study; Ka He, Anwar Merchant, et all BMJ 2003;327:777-782
Objective: To examine the association between intake of total fat, specific types of fat, and cholesterol and risk of stroke in men.
Design and setting: Health professional follow up study with 14 year follow up.
Participants: 43 732 men aged 40-75 years who were free from cardiovascular diseases and diabetes in 1986.
Main outcome measure: Relative risk of ischaemic and haemorrhagic stroke according to intake of total fat, cholesterol, and specific types of fat.
Results: During the 14 year follow up 725 cases of stroke occurred, including 455 ischaemic strokes, 125 haemorrhagic stokes, and 145 strokes of unknown type. After adjustment for age, smoking, and other potential confounders, no evidence was found that the amount or type of dietary fat affects the risk of developing ischaemic or haemorrhagic stroke. Comparing the highest fifth of intake with the lowest fifth, the multivariate relative risk of ischaemic stroke was 0.91 (95% confidence interval 0.65 to 1.28; P for trend = 0.77) for total fat, 1.20 (0.84 to 1.70; P = 0.47) for animal fat, 1.07 (0.77 to 1.47; P = 0.66) for vegetable fat, 1.16 (0.81 to 1.65; P = 0.59) for saturated fat, 0.91 (0.65 to 1.28; P = 0.83) for monounsaturated fat, 0.88 (0.64 to 1.21; P = 0.25) for polyunsaturated fat, 0.87 (0.62 to 1.22; P = 0.42) for trans unsaturated fat, and 1.02 (0.75 to 1.39; P = 0.99) for dietary cholesterol. Intakes of red meats, high fat dairy products, nuts, and eggs were also not appreciably related to risk of stroke.
Conclusions: These findings do not support associations between intake of total fat, cholesterol, or specific types of fat and risk of stroke in men.
(Ïîëó÷åííûå äàííûå íå ïîäòâåðæäàþò âçàèìîñâÿçü ìåæäó êîëè÷åñòâîì óïîòðåáëÿåìûõ æèðîâ èëè òèïîì æèðîâ è ðèñêîì èíñóëüòà ó ìóæ÷èí. — ïåð. Ê.Ì.)
Ïîçâîëüòå îáðàòèòü âàøå âíèìàíèå íà òî, ÷òî â ýòî èññëåäîâàíèå äîïóñêàëèñü òîëüêî ìóæ÷èíû, ó êîòîðûõ ê íà÷àëó èññëåäîâàíèÿ íå áûëî îáíàðóæåíî áîëåçíåé ñåðäöà è ñîñóäîâ. Ñîîòâåòñòâåííî, åñëè ìÿñî, õîëåñòåðèí è æèâîòíûå æèðû íå óâåëè÷èâàþò ðèñê èíñóëüòà, äàæå ðåáåíêó äîëæíî áûòü ÿñíî, ÷òî îíè íå óâåëè÷èâàþò è ðèñê èíôàðêòà, òàê êàê îáå áîëåçíè ñâÿçàíû ñ îäíîé è òîé æå ïðèíöèïèàëüíîé ïðè÷èíîé — àòåðîñêëåðîçîì.
Âîò è ïîëó÷àåòñÿ — òe, êòî ñ÷èòàþò, ÷òî «íåò ïðîðîêîâ â ñâîåì Îòå÷åñòâå», ïðèíèìàþò Lipitor è óñóãóáëÿþò àòåðîñêëåðîç «çäîðîâîé» äèåòîé. Òå æå, êòî ïðî÷èòàëè «Ôóíêöèîíàëüíîå ïèòàíèå» è «Íàðóøåíèÿ óãëåâîäíîãî îáìåíà» è ñëåäóþò ìîèì ðåêîìåíäàöèÿì, — óæå ìíîãî ëåò ïîëó÷àþò óäîâîëüñòâèå îò íîðìàëüíûõ, òðàäèöèîííûõ ïðîäóêòîâ è èçáàâèëèñü îò âûñîêîãî ñàõàðà, ãèïåðèíñóëèíåìèè, ïîâûøåííîãî äàâëåíèÿ — îñíîâíûõ ïðè÷èí àòåðîñêëåðîçà è, êàê ñëåäñòâèå, è èíñóëüòîâ, è èíôàðêòîâ…
Çà ðåäêèì èñêëþ÷åíèåì, àìåðèêàíñêèå âðà÷è íå ÷èòàþò British Medical Journal. Òàê ÷òî, ïîæàëóéñòà, ïîøëèòå ïî ýëåêòðîííîé ïî÷òå èëè ðàñïå÷àòàéòå ýòó ñòàòüþ äëÿ âàøåãî âðà÷à. Ìîæåò áûòü — ïîìîæåò…
Êîíñòàíòèí Ìîíàñòûðñêèé

Ñåðèÿ ñîîáùåíèé "Êîíñòàíòèí Ìîíàñòûðñêèé":
×àñòü 1 - "Áðîæåíèå è ãíèåíèå". Âûäåðæêè èç êíèãè Êîíñòàíòèíà Ìîíàñòûðñêîãî "Ôóíêöèîíàëüíîå ïèòàíèå" .
×àñòü 2 - Ìèôû î ïîëüçå êëåò÷àòêè. Ê. Ìîíàñòûðñêèé
...
×àñòü 10 - Íåñêîëüêî ôàêòîâ îòíîñèòåëüíî ïèòàíèÿ. Ê. Ìîíàñòûðñêèé
×àñòü 11 - Áåæèì îò ìàðàçìà.. Åù¸ ðàç î õîëåñòåðèíå.
×àñòü 12 - Åñòü ëè ñâÿçü ìåæäó ðèñêîì èíñóëüòà è ïèùåé, áîãàòîé æèâîòíûìè æèðàìè è õîëåñòåðèíîì? Ê. Ìîíàñòûðñêèé
×àñòü 13 - Ïèðàìèäà, íà êîòîðîé ðàñïóõëà è âûðîæäàåòñÿ Àìåðèêà…
×àñòü 14 - Êàê äàâíî âû ÷èòàëè Ìîíàñòûðñêîãî?? "Ëþáîâü ê ïå÷åíüþ áåç ñàõàðà"