Ernährung und Lebensstil spielen für die Entstehung kardiovaskulärer Risikofaktoren,
die Manifestation und Prognose der koronaren Herzkrankheit (KHK) eine entscheidende
Rolle. Von einem gesunden Ernährungs- und Lebensstil profitieren Patienten selbst
bei einem stark erhöhten genetischen Risiko für KHK. Diese Übersicht fasst die von
Erfahrungen in Populationen mit niedriger Inzidenz und von Interventionsstudien ableitbaren
Ratschläge zusammen.
Abstract
Diet and lifestyle have an important impact on the development of cardiovascular risk
factors, the manifestation of coronary heart disease, and the prognosis after a cardiovascular
event. Even in the presence of strong genetic predisposition patients benefit from
a healthy lifestyle with respect to coronary heart disease. Much of the effectiveness
of lifestyle interventions is supposedly due to their broad influence on all major
risk factors as there are overweight, central obesity, lipid disorders, hypertension,
and diabetes mellitus type 2, but also due to independent mechanisms. A Mediterranean
diet has been repeatedly shown to reduce cardiovascular events by exchange of several
nutrients among others preferring olive oil or nuts, even without measurable impact
on conventional risk factors. A diet rich in fruit, vegetables and low-fat milk products
and limited in salt and calories if appropriate is considered evidence-based for reducing
elevated blood pressure and prevention of coronary heart disease. In terms of insulin
resistance and prevention of type 2 diabetes the multimodal interventions of the diabetes
prevention studies have set the gold standard. Strictly avoiding nutrients rich in
those fatty acids (lauristic, myristic, palmitic acid) that increase cholesterol synthesis
and reduce hepatic LDL-uptake have proven effective for lowering LDL-cholesterol.
Even in clinically overt coronary heart disease, diet, physical activity, and stress
management can induce regression of coronary stenoses and reduce angina pectoris.
Diet and lifestyle may be employed as a sole preventative measure, but also combined
with medication. Recommendations need not only consider the individual risk profile,
but also the personal preferences to ensure adequate adherence.
Schlüsselwörter Ernährung - Ernährungsmuster - Lebensstil - kardiovaskuläres Risiko - koronare Herzkrankheit
Keywords nutrition - dietary pattern - lifestyle - cardiovascular risk - coronary heart disease
