????????对不少老年慢性病患者来说,每年的冬天都是一个关口。防治心脑血管病必须重视并加强高血压、高血脂、高血糖、高同型半胱氨酸血症等危险因素的防治及慢病管理。武警广东省总队医院营养科主任曾晶从饮食和营养方面给广大高血压患者如下建议。

? ?? ?? ?? Every winter is a gateway for many elderly people with chronic diseases. The prevention and treatment of cardiovascular and cerebrovascular diseases must pay attention to and strengthen the prevention and treatment of risk factors such as hypertension, hyperlipidemia, hyperglycemia, hyperhomocysteinemia and chronic disease management. Zeng Jing, director of the nutrition department of the Guangdong Provincial General Hospital of the armed police, gave the following advice to the majority of patients with hypertension from the aspects of diet and nutrition.

????????曾晶介绍,高血压分为原发性高血压和继发性高血压。继发性高血压,顾名思义,是其他疾病的伴发症状或者并发症,例如急慢性肾脏疾病、肾血管狭窄、内分泌疾病、妊娠期等都可能出现血压升高。继发性高血压的饮食原则需以原发病为主,同时兼顾高血压的饮食注意事项。原发性高血压,也就是高血压病被认为是一种生活方式病,加强生活方式调节及慢病管理对原发性高血压病的预防和治疗有积极作用。

? ?? ?? ?? Hypertension is divided into essential hypertension and secondary hypertension. Secondary hypertension, as its name implies, is associated with symptoms or complications of other diseases, such as acute and chronic kidney disease, renal vascular stenosis, endocrine diseases, pregnancy may have increased blood pressure. The dietary principle of secondary hypertension should focus on the primary disease and take into account the dietary precautions of hypertension. essential hypertension, that is, hypertension is considered as a lifestyle disease. strengthening lifestyle regulation and chronic disease management has a positive effect on the prevention and treatment of essential hypertension.

????????曾晶表示,为了减少患高血压病的风险,首先需要控制体重,避免超重和肥胖。超重的人发生高血压的风险是体重正常人的3~4倍,肚子大腰粗(男性≥90cm、女性≥85cm)也会增加高血压的风险。合理膳食,饮食有规律、有节制是体重管理的基础。其次,吃得过咸,膳食中钠的摄入量过多、钾的摄入不足、抗氧化维生素摄入不足也是高血压的危险因素。第三要戒烟戒酒。第四要劳逸结合、加强锻炼。精神紧张、体力活动缺乏、熬夜等不良生活方式是高血压、糖尿病等慢性非传染性疾病的危险因素。

? ?? ?? ?? To reduce the risk of hypertension, Mr Tsang said, weight control was needed to avoid being overweight and obese. People who are overweight are three to four times more likely to have high blood pressure, and having a big waist (male ≥90cm, female ≥85cm) can also increase the risk of high blood pressure. Rational diet, regular diet, control is the basis of weight management. Secondly, eating too salty, excessive intake of sodium in the diet, insufficient intake of potassium and insufficient intake of antioxidant vitamins are also risk factors for hypertension. Third, quit smoking and alcohol. Fourth, work and rest should be combined to strengthen exercise. Mental stress, lack of physical activity, staying up late and other bad lifestyle are risk factors for chronic non-communicable diseases such as hypertension and diabetes.

????????曾晶建议,已经诊断为高血压病的患者更应该采取健康的生活方式,坚持遵医嘱服用降压药物,而不能擅自按自身感觉不规则服药;坚持定期监测血压和体检。除了定时作息、劳逸结合、放松心态、坚持体育活动外,饮食上还需要改变不良的饮食习惯,食物选择和烹饪方式方面注意一些细节。

? ?? ?? ?? ? Zeng Jing suggested that patients who have been diagnosed with hypertension should adopt a healthy lifestyle, adhere to the doctor's advice to take antihypertensive drugs, and do not take the medicine according to their own feelings irregularly; adhere to regular monitoring of blood pressure and physical examination. In addition to regular rest, combination of work and rest, relaxation of mind, adherence to physical activity, diet also needs to change bad eating habits, food selection and cooking style to pay attention to some details.

????????1.低盐饮食。《中国居民膳食指南(2016年)》建议成年人一日盐的摄入量不超过6g,调查显示,即便在公认“饮食清淡”的广东地区,每日膳食盐的摄入量也在9~12g。实施低盐饮食,除了烹饪中使用量匙控制盐的用量,还有一些需要注意的细节:少吃腌制熏制食品;烹饪后期放盐,也就是临起锅时再放盐调味可以减少盐的用量;使用蘸料碟,如白切、白灼等烹饪方式可以减少盐的摄入;不用菜汁捞饭可以减少油脂和盐的摄入量;除了食盐,还需要减少“隐形盐”的摄入,例如味精、鸡精、酱油、蚝油、陈醋等调味酱料钠的含量很高,很多食品添加剂如色素、防腐剂等都是以钠盐的形式存在,包装食品中的钠的含量也不容小觑。

? ?? ?? ?? ?1。 Low salt diet. The Dietary Guidelines for Chinese Residents (2016), which advises adults to eat no more than 6g of salt a day, showed that the daily intake of salt was between 9 and 12g in Guangdong, where the diet is considered "light ". In addition to using a low-salt diet to control the amount of salt used in cooking, there are some details to pay attention to: eat less pickled and smoked food; put salt in the later stage of cooking, that is, put salt in the pan before the salt seasoning can reduce the amount of salt; use dipping dish, such as white cut, white burning and other cooking methods can reduce salt intake; do not use vegetable juice to fish rice can reduce the amount of oil and salt intake; in addition to salt, also need to reduce the "invisible salt" intake, such as monosodium glutamate, chicken essence, soy sauce, oyster sauce, aged vinegar and other sauce sodium content is very high, many food additives such as pigment, preservatives are in the form of sodium salt, packaging sodium content is not to be underestimated.

????????2.控制膳食总能量和饱和脂肪酸的摄入量。合理的膳食总能量与体力活动及代谢相适应。如果体重超重、肥胖或者腰粗肚凸,建议咨询营养医师进行规范的代谢调理和慢病管理,不要自己盲目减肥,甚至乱用一些减肥产品。少吃动物脂肪,例如牛油、肥肉、肉皮等,减少饱和脂肪酸的摄入量。

? ?? ?? ?? ?2。 controlling the intake of total dietary energy and saturated fatty acids. reasonable total dietary energy adapted to physical activity and metabolism. If overweight, obese or waist bump, it is recommended to consult a nutritionist for standardized metabolic conditioning and chronic disease management, do not blindly lose weight, or even use some weight loss products. Eat less animal fat, such as butter, fat, meat skin and so on, reduce the intake of saturated fatty acids.

????????3.营养均衡,不要误信“高血压病人不能吃肉”的谣言,适量补充蛋白质,增加有利于降压的营养素如钾、镁、钙等的摄入量,适量增加新鲜的蔬菜和水果,每天每人吃8两~1斤左右新鲜蔬菜(叶菜和瓜菜为主)、1~2个水果,250~500毫升脱脂或低脂牛奶,或者酸牛奶。

? ?? ?? ?? ?3。 Balanced nutrition, do not mistakenly believe that "high blood pressure patients cannot eat meat" rumors, appropriate amount of protein supplement, increase the intake of nutrients such as potassium, magnesium, calcium and other beneficial to reduce blood pressure, appropriate amount of fresh vegetables and fruits, each eat 8 to 1 jin of fresh vegetables (leafy vegetables and melon vegetables mainly),1 to 2 fruits,250 to 500 milliliters of skim or low fat milk, or sour milk.

????????4.多吃含膳食纤维丰富的食物、保证大便通畅,可以减少高血压患者心脑血管急性事件的发生。黑米、糙米、全麦等粗粮,绿豆、玉米、荞麦等杂粮,绿叶及豆荚类蔬菜,苹果、桃、梨、火龙果、奇异果等水果,这些都是膳食纤维的良好来源,建议多选择。

? ?? ?? ?? ?4。 Eating more food with abundant dietary fiber and ensuring smooth stool can reduce the occurrence of acute cardiovascular and cerebrovascular events in patients with hypertension. Black rice, brown rice, whole wheat and other coarse grain, mung bean, corn, buckwheat and other miscellaneous grain, green leaves and pod vegetables, apple, peach, pear, dragon fruit, kiwi fruit and other fruits, these are good sources of dietary fiber, it is recommended to choose more.

????????5.戒烟限酒,最好戒酒。烟和酒都会使降压药的疗效降低,导致血压控制不佳,从而引发不良预后。(全媒体记者梁超仪通讯员田乃伟)

? ?? ?? ?? ?5。 Quit smoking and limit alcohol. Both smoke and alcohol can reduce the efficacy of antihypertensive drugs, resulting in poor blood pressure control, and thus lead to poor prognosis. (Media Reporter, Mr Leung Chiu-yee, Mr Timothy TAI Nai-wai)


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