The problem of preventing cardiovascular morbidity and mortality is very relevant. The majority of scientists and clinicians hope that its solutions will be associated with the achievements of modern pharmacology in the development and implementation of new antihypertensive, antithrombotic and lipid-lowering drugs. Since the formation of cardiovascular pathology is a multifactorial process, it is logical to believe that polypharmacotherapy should have a better chance of success.

In 2003, a special kit ("Polypill") was proposed using several drugs (statin, 2-3 antihypertensive drugs, folic acid and aspirin), which reduces the risk of developing cardiovascular disease by more than 80%. Despite the fairly high efficacy of the pharmacological complex, its widespread use in practice was limited by the high cost, the possible adverse effects of the drugs, as well as the psychological rejection by patients of the need for prolonged simultaneous use of several drugs.

At the same time, evidence has been accumulated indicating that the pharmacological approach to the correction of cardiovascular disorders is not the only one. Thus, a number of studies have shown the preventive effect of certain foods. Despite the fact that the list of these products is quite long, there is not for each of them reliable evidence of effectiveness.

The choice of food products that have the greatest preventive effect on the development of cardiovascular disease was made by a group of European scientists who decided to create a special diet, the effectiveness of which would be comparable to the effectiveness of drugs. Based on the results of controlled clinical trials and meta-analyzes, they included in the diet only products whose positive effect (if used individually) corresponded to the first and second level of evidence. As a result, the ingredients they compiled (Polymeal) included the following ingredients: wine, fish, dark chocolate, fruits, vegetables, almonds and garlic.

It has already been found that the daily consumption of 150 ml of red wine reduces the incidence of cardiovascular disease by more than 30%, 100 g of chocolate - by more than 20% and 114 g of fish 4 times a week - almost 15%. Perhaps the effect of chocolate is associated with its effect on blood pressure. Thus, a bar of chocolate helps reduce systolic blood pressure by 5.1 mm Hg and diastolic - by 1.8 mm Hg. The use of 600 to 900 mg of garlic powder (corresponding to 1.8 to 2 , 7 g of fresh garlic) of 0.44 mmol / L per day reduces the total cholesterol level in the blood and by 38% the risk of cardiovascular diseases. Fruits and vegetables can also lower blood pressure, and almonds lower cholesterol, so they have also been included in the diet, although their effect on cardiovascular morbidity and mortality has not been studied enough.

By combining the food products in a prophylactic kit, the authors assume that their combined use will be more effective than using it separately. To confirm this, the nutritional characteristics were analyzed for 46 years from a cohort made up of 5209 patients living in the city of Framingham (USA) and examined for many years to identify the risk factors for cardiovascular diseases as part of the so-called Framingham study. The study's "endpoints" were the incidence of cardiovascular disease and cardiovascular death, as well as the frequency of death from other causes.

The results of the study exceeded all expectations: the diet increased the life expectancy of men by 6.6 years and women by 4.8 years. Its use has been accompanied by a 76% drop in cardiovascular morbidity! The projective effect of the diet was more stable in people over 50 years of age.

The authors could not determine whether the prophylactic effect was increased with an increase in the consumption of these ingredients compared to the recommended amount. At the same time, reducing or completely excluding any component of the diet (while maintaining all the other components) has resulted in a decrease in the effectiveness of the diet. Particularly notable consequences were caused by the lack of wine in the diet, which reduced its preventive value by 11%. The omission of other ingredients was accompanied by lesser consequences: without garlic, the effect of the diet was 8% lower, without chocolate by 6%, without almonds by 3% and without fish by only 1%.

Demonstrating a pedantic approach to evaluating the proposed method for the prevention of heart disease, the diet compilers, in addition to its effectiveness, took into account the possible undesirable consequences of using this food set. The most difficult product to tolerate was garlic: people who consumed it complained of a characteristic odor emanating from the oral cavity and the body. Other products have caused side effects only in case of overdose. For example, in the blood of people who ate fish in excess of the recommended levels, an increased mercury content was found. It should be noted that we are talking about the use of shark meat and swordfish for food. Among the side effects, which have not been proven to be related to the use of food, there may be an increase in gas formation and abdominal pain. Allergic reactions have also occurred.

The components of the diet are generally easily compatible with commonly consumed foods. However, it is not recommended to combine the diet with alcoholic beverages not included in the list of food ingredients. As the authors rightly note, excess alcohol can lead to unnecessary conflicts with friends, relatives and at work, the negative consequences of which can reduce the positive impact of eating.

Given these undesirable effects observed in individuals who adhered to the diet, its authors considered it necessary to give some recommendations concerning the rules of its use. Thus, the use of one of the most active components of the diet - wine dictates the need to refuse to drive a car as soon as possible after consuming a whole diet. It is not recommended to exchange garlic for a romantic date, however, this rule can be reserved if the partner you meet is also a member of this diet.

Therefore, a diet containing the ingredients listed should be considered effective and safe. According to the authors of the plan, the proposed method for the prevention of cardiovascular disease will cost the consumer no less than the pharmacological preparations, it may even be a little less effective than the drugs, but it will be much more tasty and will undoubtedly be very requested. The cost of food packaging of course depends on the region in which it is purchased. Anyway, the authors of the diet do not particularly recommend saving on the purchase of appropriate products, noting that the pleasure obtained by drinking good wine and your favorite variety of chocolate will certainly strengthen the preventive effect.

"We think we have been able to identify all the main products that can reliably reduce the risk of heart disease. At the same time, some other nutritional components, whose positive effects are not so obvious, may also be useful," warn. the plan's warnings. These include olive and soybean oil, soybeans, tomatoes, oats, bran, corn, peas, nuts and tea. These products should be considered as an addition to the main components of the diet, which can increase its effectiveness.

It should be noted that there is no reason to limit preventive measures for cardiovascular disease only to diet. So half an hour daily walks are also very helpful in this regard. For people who, for whatever reason, should pay maximum attention to the prevention of cardiovascular disease, an appropriate combination of diet and medication seems appropriate.

The authors hope that including the components of their diet in a variety of culinary recipes will make the prevention of cardiovascular disease attractive to a large population. If cardiologists and therapists believe in the preventive effect of food, the time will come when it will be appropriate to go to the grocery store or to the restaurant with a prescription received at the clinic.