Category Archives: Heart Disease

PURE Study: Higher Carb Consumption Linked to More Deaths

Here’s the abstract of a new epidemiological study that investigated the relationships between diet, cardiovascular disease, and death rates. I don’t have the entire article. My sense is that the 18 countries studied are mostly non-Western:

Background

The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.

Methods

The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.

Findings

During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

Interpretation

High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

Source: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet

Mediterranean Diet Lowered Blood Pressure By a Whopping 1 Point

Or more accurately, 1.1 to 1.3 mmHg over the course of six months in an Australian population. Systolic pressure, if you’re wondering. This isn’t clinically significant.

Details:

“A total of 166 men and women aged >64 y were allocated via minimization to consume either a MedDiet (n = 85) or their habitual diet (HabDiet; control: n = 81) for 6 mo. The MedDiet comprised mainly plant foods, abundant extra-virgin olive oil, and minimal red meat and processed foods. A total of 152 participants commenced the study, and 137 subjects completed the study. Home blood pressure was measured on 5 consecutive days at baseline (n = 149) and at 3 and 6 mo. Endothelial function (n = 82) was assessed by flow-meditated dilatation (FMD) at baseline and 6 mo. Dietary intake was monitored with the use of 3-d weighed food records. Data were analyzed with the use of linear mixed-effects models to determine adjusted between-group differences.Results: The MedDiet adherence score increased significantly in the MedDiet group but not in the HabDiet group (P < 0.001). The MedDiet, compared with the HabDiet, resulted in lower systolic blood pressure (P-diet × time interaction = 0.02) [mean: −1.3 mm Hg (95% CI: −2.2, −0.3 mm Hg; P = 0.008) at 3 mo and −1.1 mm Hg (95% CI: −2.0, −0.1 mm Hg; P = 0.03) at 6 mo]. At 6 mo, the percentage of FMD was higher by 1.3% (95% CI: 0.2%, 2.4%; P = 0.026) in the MedDiet group.”

Source: AJCN | Mobile

Is Drinking Tea Healthful?

Green tea isn’t always green

From P.D. Mangan’s new book “Best Supplements for Men“:

Green tea, which is commonly drunk in China and Japan, is associated with lower rates of cancer, about 30% lower in those who drank the highest amounts of green tea compared to the lowest. Deaths from cardiovascular disease were about 25% lower in the highest consumption group versus the lowest. This is of course epidemiological evidence, meaning that it can’t show whether green tea actually prevented disease, or that there’s some other connection such as that heather people drank more green tea.

Laboratory and other evidence, however, provides some good reasons to think that green tea is the real deal when it comes to sides prevention.

A recent study of the elderly in Singapore found tea consumption linked to much lower risk of neurocognitive decline in women and carriers of the “dementia gene” APOE ε4.

P.D. suggests that the health-promoting dose of tea is 3 to 5 cups a day, and black tea may be just as good as green.

Steve Parker, M.D.

 

Monica Reinagel Considers Whether Calcium Supplements Are Safe or Not

 

Death in a bottle?

Death in a bottle?

Monica is a smart and media-savvy nutritionist who brought me on board as a blogger at NutritionData many years ago. Click the link below for her surprising conclusion on calcium supplementation.

Monica writes:

“The National Osteoporosis Foundation published a new report this week, insisting that calcium supplements are safe for your heart. Two weeks ago, Johns Hopkins cardiologist Erin Michos published a paper saying the opposite.

She claims that the NOF review (which was funded by a pharmaceutical company that makes calcium supplements) omitted certain studies (such as the ones she included in her own review) that might have changed the conclusion.

These are just the latest two volleys in a five-year-long tennis match between experts on whether you should or shouldn’t take calcium supplements.  And you thought politics was divisive.”

Source: Calcium Supplements: Safe or Not?

New Study: Mediterranean Diet Prevents Cardiovascular Disease in British Adults

This tower is in Pisa, Italy

This tower is in Pisa, Italy

This won’t surprise you if you’ve been reading this blog for a while:

“Heart disease is the leading cause of death for both men and women in the United States, killing around 610,000 people annually. Heart attack affects around 735,000 Americans each year, while around 800,000 people are affected by stroke.

Adopting a healthy diet is considered key for reducing the risk of CVD, and numerous studies have suggested the Mediterranean diet fits the bill.

A study published in the European Heart Journal earlier this year, for example, found older adults who adhered to the Mediterranean diet were at lower risk of heart attack, stroke, and cardiovascular death than those who followed a Western diet.”

Source: Mediterranean diet linked to reduced risk of CVD – Medical News Today

Steve Parker, M.D.

PS: If you like having a healthy heart, you might like my books.

Resistance Training Cuts Risk of Diabetes and Cardiovascular Disease in Middle-Aged Women

That's a dumbbell in her right hand. I work-out with those myself.

That’s a dumbbell in her right hand. I work-out with those myself.

I don’t have access to the full scientific report, but I’ve posted part of the abstract below.

The biggest problem with the study at hand is that physical activity apparently was surveyed only at the start of this 14-year study. Results would be much more robust if activity was surveyed every year or two. My overall activity level seems to change every two or three years. How about you?

Moving on.

“Compared to women who reported no strength training, women engaging in any strength training experienced a reduced rate of type 2 diabetes of 30% when controlling for time spent in other activities and other confounders. A risk reduction of 17% was observed for cardiovascular disease among women engaging in strength training. Participation in both strength training and aerobic activity was associated with additional risk reductions for both type 2 diabetes and cardiovascular disease compared to participation in aerobic activity only.

CONCLUSIONS: These data support the inclusion of muscle-strengthening exercises in physical activity regimens for reduced risk of type 2 diabetes and cardiovascular disease, independent of aerobic exercise. Further research is needed to determine the optimum dose and intensity of muscle-strengthening exercises.”

PMID 27580152

Source: Strength Training and the Risk of Type 2 Diabetes and Cardiovascular Disease. – PubMed – NCBI

Steve Parker, M.D.

PS: Cardiovascular disease includes heart attack, cardiac death, stroke, coronary angioplasty, and coronary artery bypass grafting.

Eating Fish Is Still Good For You

Dead whole fish aren't very appealing to many folks

Dead whole fish aren’t very appealing to many folks

Heart disease is still the #1 killer in the U.S., followed by cancer and chronic lower respiratory tract disease. “Heart disease” is a broad category; the primary killer is heart attacks.

Eating fish regularly seems to reduce your risk of heart attack. I favor the cold-water fatty fish like salmon, trout, herring, and sardines.

I quote the NYT:

“Numerous studies have found that people who eat fish on a regular basis are less likely to die of a heart attack than those who don’t eat it or eat it less than once a month, and a 2006 Harvard review concluded that eating one to two servings of fish rich in omega-3s every week cut the risk of dying of a heart attack by one-third.”

Source: Why Is Fish Good for You? Because It Replaces Meat? – The New York Times

PS: Accidents are the #4 cause of death, and suicide is #10.

PPS: Click for ideas on reducing your risk of cancer.