控制鸡蛋和黄油的摄入（9/9）

At the opposite extreme from the Melmans are people who seem to be genetically programmed to escape the problem. The Pima Indians of Arizona have the world's highest known rate of diabetes and one of the highest rates of obesity, both of which should increase their risk of heart disease. To make matters worse, they subsist on a diet heavy in foods fried in lard. Despite all this, Pimas have moderately low levels of LDL and only about one-fourth the heart-attack rate of the American public. Scientists believe that what makes the Pimas different from the more vulnerable masses is not that their bodies produce less cholesterol, but rather that they are more efficient at removing it from the bloodstream. Says Barbara Howard, a researcher for the National Institutes of Health: "The Pimas may have more LDL receptors or else more efficient ones than most people."

与Melmans一家相反的极端例子是，那些遗传良好的人们应付这个问题似乎易如反掌。亚利桑那州的皮马印第安人糖尿病和肥胖发生率是世界最高的，所有的这些都提升了他们的心脏病发生率。让事情更糟的是，他们日常食用的食品都被猪油煎炸过。除此之外，皮马人与其他人一样拥有较低的LDL含量，而他们的心脏病发生率只占全美的四分之一。科学家们认为之所以会有这种结果，不是因为他们的身体会生成较少的胆固醇，而是因为他们能更有效的把胆固醇从血液里排除出体外。Barbara Howard提到了国家健康协会的研究报告：“尽管皮马人自身能承受更多的LDL，与其他人相比，他们还能更有效地把LDL排出体外。”

The same may be true for the 1% to 2% of Americans who, according to Rockefeller University Geneticist Jan Breslow, "have a genetic composition that makes them immune to atherosclerosis." Breslow calls this advantage "the Winston Churchill factor." Says he: "These people break all the rules; they eat eggs, bacon and meat, and they smoke. And they live to be 95."

与其相似，洛克菲勒大学遗传学家Jan Breslow证实，大约有1%到2%的美国人“拥有免于发生动脉硬化的基因。”他说：“这些人违背着所有的‘健康饮食’原则；他们吃鸡蛋、培根和肉，还抽烟。但是他们可以活到95岁。”

For the 98% of Americans who are neither Winston Churchills nor Pimas, playing by the rules is important. It is a rare doctor, however, who will recommend dietary reform to a patient unless his cholesterol level is already quite high or he has suffered a heart attack. "Most physicians are used to treating acute illnesses; they are less comfortable with preventive medicine for healthy-looking patients," says Dr. Eugene Passamani, associate director for cardiology at the National Institutes of Health. As a result, individuals must usually make up their own minds about a change in diet. The trends of the past two decades give cause for optimism. Medical researchers generally believe that Americans will become increasingly willing to change to a healthier diet and a more sensible lifestyle. By the year 2000, they say, heart disease could cease to be the leading cause of death in America. Twenty years ago, says Dr. William Friedewald of the N.H.L.B.I., "the public attitude was fatalistic: 'You may get a heart attack or you may not.' Today Americans are beginning to realize their health is in their own hands."

不过98%的美国人可没有Winston Churchills或者皮马人的体质，因此执行这些原则是很重要的。这是最好的医生，特别是对那些胆固醇过高和被心脏病威胁过的人们来说。国家健康协会心脏病学主任Eugene Passamani教授说：“大多数的医学治疗都是针对急性病的；并不适合于那些看起来健康的人们作预防治疗用。”因此，人们都致力于改变自己的饮食结构。而过去二十年的变化趋势还是值得乐观地看待的。医疗研究者普遍相信美国人越来越倾向于采用更健康的饮食方案，和一个更明智的生活方式。他们认为，到2000年，心脏病将不再是美国人死亡的主要病因。二十年前，美国国立心肺及血液研究会的William Friedewald教授说：“社会舆论曾经对此抱有一种宿命论：‘你可能会患上心脏病，也可能不会。’而今天的美国人开始相信他们的健康掌握在自己手上。”