著者

奥山 治美 大原 直樹

出版者

日本脂質栄養学会

雑誌

脂質栄養学 (ISSN:13434594)

巻号頁・発行日

vol.26, no.1, pp.75-88, 2017 (Released:2017-05-21)

参考文献数

29

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Recently, close correlations of cardiovascular disease(CVD)with diabetes and chronic kidney disease have been emphasized although the causal relationshipsremain to be defined. Current nutritional guidelines for the prevention of these diseases issued from authoritative organizations are consistent with those proposedby a group of Harvard University School of Public Health(Harvard-SPH School) that the intakes of saturated and trans fats should be reduced while increasing that of polyunsaturated linoleic acid in order to lower LDL-C/HDL-C ratio and thereby reduce CVD. The Harvard-SPH School was based on epidemiological studies with unavoidable biases, and more reliable RCT studies reported the opposite conclusions; long-term interventions based on the cholesterol hypothesis resulted in increased CVD and all-cause mortality. Moreover, treatments with statins effectively lowered LDL-C/HDL-C ratios but were essentially ineffective in preventing CVD as shown in RCT trials performed after 2004/5, when new regulations on clinical trials came into effect in the EU and US. Alternatively, we revealed pharmacological mechanisms of statins and warfarin to stimulate atherosclerosis and heart failure. Moreover, some types of vegetable oils were shown to share a mechanism common to statins that they inhibit vitamin K2-dependent processes leading to various lifestyle related diseases. Our nutritional recommendations for the prevention of these diseases are, ①increasing the intake of foods with low ω6/ω3 ratios, ② reducing fats and oils with vitamin K2 inhibitory activities, and ③ evaluating animal fats and cholesterol to be beneficial for the prevention of stroke, but not risky for the development of CVD.