International Journal of General Medicine | Volume 15 - Dove Press
Eat More Of These 6 Foods To Lower Your Risk Of Heart Disease, New Research Says
miniseries/Getty Images
Making six key foods a regular part of your diet may lower your risk of cardiovascular disease, new research shows.
For the study, published in the European Heart Journal, researchers analyzed data from six international studies that included 245,000 participants—with and without prior cardiovascular disease—from 80 countries. They used a diet score from the Prospective Urban and Rural Epidemiological (PURE) study, ongoing research run by the Population Research Health Institute.
The researchers found that having a diet filled with whole fruits, vegetables, legumes, nuts, fish, and whole-fat dairy products helped lower a person's risk of cardiovascular disease, including heart attacks and strokes.
"The biggest gains in avoiding premature cardiovascular disease and deaths globally is expected to occur by increasing the intake of healthy foods to a moderate degree, especially in poorer world regions," Andrew Mente, MSc, PhD, lead researcher for the study and associate professor at McMaster University, told Health.
Mente highlighted that the study was global in scope instead of centered on high-income or Western countries, the focus of many previous diet studies. He said those studies may not apply to people who live in lower to middle-income countries, where inadequate intake—rather than excess consumption—of certain foods may cause health issues.
Cardiovascular diseases are the leading cause of death globally, resulting in an estimated 17.9 million deaths each year, according to the World Health Organization. A third of those deaths occur prematurely in people younger than 70. An unhealthy diet lacking protective foods such as vegetables and whole grains is considered a main cardiovascular disease risk factor.
"This study emphasizes the power of nutrition, and that low intakes of heart healthy foods are associated with poor outcomes," Martha Gulati, MD, director of preventive cardiology and associate director of the Preventive and Rehabilitative Cardiac Center in the Smidt Heart Institute at Cedars-Sinai, told Health.
Based on their findings, the researchers recommend eating two to three daily servings of both fruit and vegetables, two daily servings of dairy, and one daily serving of nuts. "The score also includes three to four weekly servings of legumes and two to three weekly servings of fish," Mente said. "Possible substitutes included whole grains at one serving daily, and unprocessed red meat or poultry at one serving daily." This study differs from other papers because researchers focused on a broad range of natural foods eaten in moderation rather than a diet limited to a small number of foods, Sheri Berger, RDN, CDCES, registered dietitian nutritionist at El Camino Hospital Cardiac & Pulmonary Wellness Center, told Health. "[Their findings] suggest it is better to consume key quality foods such as fruits, vegetables, nuts, legumes, fish, and dairy rather than focus on limiting foods high in saturated fat such as whole fat dairy and meat," she said. Including certain foods while not limiting others may make the PURE diet easier to stick to than other diets, ultimately resulting in better cardiovascular outcomes, said Gulati. She noted that "the most interesting aspect of this study" is the finding that dairy—about two daily servings of whole-fat milk, yogurt, or cheese—can be included with other beneficial foods as part of a nutritious diet. "We advise, currently, that the consumption of saturated fat—which often comes from animal products—increases the risk for cardiovascular disease and this study does not support that," she said. "We may need to re-evaluate how we advise about whole-fat [dairy] products but I still think that it is more [that] the diet was overall better." The study also provided more evidence that increasing consumption of foods known to be cardio-protective—fish, nuts, vegetables, and legumes—does indeed protect heart health, said Gulati. An inclusive plant-based diet is a great choice for heart disease prevention, said Berger. This type of diet focuses on whole plant foods like fruits, vegetables, legumes, and nuts. However, dairy and quality protein from animals can be included too. "For example, meals could feature a large portion of colorful fruits and vegetables, quality protein from fish, meat, nuts, and/or legumes, fiber rich whole grains such farro, brown rice, or quinoa, and a source of dairy a couple times per day," Berger said. "Generally, there is no one magic food or property of one food that by itself protects the heart. It is what we eat regularly that will affect heart health and overall health." There's no need to worry if you can't eat nuts, fish, or any of the other recommended foods identified in the study, experts told Health. Not having them in your diet doesn't necessarily mean you're at greater risk for cardiovascular disease. Mente said researchers observed the biggest health gains with a diet score of four out of a maximum of six, with modest additional health benefits with scores above four. "So improving intake in even three or four of these foods would produce a marked protection," he said. Nuts can also be replaced with pumpkin seeds, chia seeds, or ground flaxseed, said Gulati. Additionally, algal oil supplementation can fill in nutrient gaps for omega-3s. Gulati noted that a heart-healthy diet doesn't include large amounts of foods high in saturated fats and should include no trans fats, such as fried foods and packaged baked goods. She said that many processed foods tend to be a mainstay of diets worldwide because they are relatively cheap and easy to access. These foods don't make as much room for heart-healthy foods in a person's diet. "We all need variety in our diet, and joy with the meals we eat, which is partially the food, [but also] the access to healthy food choices," Gulati said. "The important element is overall diet quality from nourishing foods."FDA Pet Food Investigation: What To Know About Diet-related Heart Disease
Since the Food and Drug Administration first warned about a possible link between a potentially fatal canine heart condition and "grain free" pet foods in 2018, owners and veterinarians have continued to report cases of dogs developing diet-related dilated cardiomyopathy, or DCM.
DCM is a disease in which the heart gets larger, leaving it weaker and less able to pump blood. Some larger breeds of dogs, such as golden retrievers and Great Danes, are susceptible to the condition.
The FDA's most recent tally of dogs, and a much smaller number of cats, with diet-related DCM included 1,382 cases, 255 of which had been determined between Aug. 1, 2020 and Nov. 1, 2022.
In 2019, the FDA named 16 brands of dog food associated with the rare form of heart disease, although it didn't suggest that owners stop giving the food, which often contains high levels of peas, lentils and potatoes, to their pets.
Oliver, left, and Riley in Cape Cod. (Julie Carter)
Researchers and veterinarians don't yet know exactly how dog and cat food might cause damage to some pets' hearts, but a study published in 2021 suggested that a culprit could be the high levels of peas in certain pet foods.
That finding was backed up in May when Canadian scientists published a study on the effects of a 28-day diet on eight adult beagle dogs, a breed chosen because it's not known to be susceptible to the heart condition. The veterinary researchers from the University of Saskatchewan fed the dogs one of three diets: a traditional diet; a grain-free diet high in lentils; and a grain free diet high in peas. They then repeated the experiment with the other two diets so that all the beagles had experience with all three diets. The researchers observed "DCM-like changes" in dogs that had been consuming the pea diet for 28 days.
It's not yet clear what it is about peas that could be harming pet hearts, said the study's senior author, Lynn Weber, a professor of veterinary biomedical sciences at the University of Saskatchewan Western College of Veterinary Medicine.
One possibility is the amount of fiber in peas. "I suspect if we remove all peas from all dog and cat foods we're still going to run into a problem," Weber said, noting that more research is needed to find out what it is about the peas and possibly other ingredients that is leading to heart damage.
The best evidence relating DCM to certain diets is how dogs' hearts improve once they are switched to a traditional diet, said Dr. Aly Cohen, an associate veterinarian at the Riney Canine Health Center and a clinical instructor at the Maddie's Shelter Medicine Program at Cornell University's School of Veterinary Medicine.
The peak in the number of reports — 608 between May 1, 2019, and July 31, 2020 — came shortly after the FDA released the brand names of the pet foods that appeared to be linked to the development of DCM.
While the rate of new cases seems to have slowed, experts say the problem may be more widespread than the number of reports suggests.
Dr. William Rausch says his cardiology practice still sees about one new case every week. And because studies have found that dogs can be developing DCM for years without symptoms, "it suggests that for every case I see there are many more [dogs] walking around out there that seem normal but are developing the disease," said Rausch, a veterinary cardiologist in private practice and an adjunct professor at the University of Washington in Seattle.
The FDA hasn't recalled any pet food products, and the agency doesn't plan to release further public updates until "there is meaningful new scientific information to share," agency spokeswoman Veronika Pfaeffle said in an email.
The Pet Food Institute, an industry group that represents most pet food companies in the U.S., appreciates the FDA's attention to the issue, Sherri Kirk, a spokesperson for the organization, said in an email. "Our members continue to conduct research to determine the highest quality and safest ingredients to provide complete and balanced dog food to help dogs live long and healthy lives."
For the most part, dogs don't show any signs until they are experiencing heart failure, said Dr. Terri DeFrancesco, a professor of cardiology and critical care at North Carolina State University College of Veterinary Medicine.
Signs that a dog is developing heart failure include:
Decreased activity.
Tiredness.
Lethargy.
Coughing.
Shortness of breath.
Decreased appetite.
For dog and cat owners, the discovery that carefully chosen foods could have damaged the heart of a beloved pet can be wrenching.
Julie Carter was stunned when her 3 1/2 year old golden retriever Oliver was diagnosed first with a heart murmur and then, after an echocardiogram, with full-blown DCM in February 2018. A short time after that, Carter's other golden retriever was diagnosed with DCM but at an earlier stage than Oliver.
After explaining the condition, Carter's vet asked what type of dog food Oliver had been eating. "It was really horrifying to think that I could have in any way been responsible because of my choice of his diet," the Florham Park, New Jersey, resident told NBC News.
Carter switched both dogs to a food with a more traditional formulation and started them on heart medication. But the damage to Oliver's heart was too great and within six months, he died. Carter's other dog, Riley, eventually recovered.
Julie Carter with her Golden Retriever, Oliver, who was diagnosed first with a heart murmur and then, after an echocardiogram, full-blown DCM in February of 2018. (Courtesy Julie Carter)
Before the first FDA advisory, some vets had already been seeing cases of DCM that appeared to be related to certain dog foods.
"The first case I saw was in 2017," said DeFrancesco.
The veterinary cardiologist said she used to report every case, but with news coverage on the issue and the loss of the staff member who used to handle FDA reports, she has stopped. It's likely that the reports to the FDA are just the tip of the iceberg because many owners and vets don't have time to fill out the forms, DeFrancesco said.
DeFrancesco believes that diet-related DCM is most likely multifactorial, with some pets inheriting a genetic susceptibility that is triggered by certain types of diets.
"Millions of dogs eat these diets but millions do not get DCM," she said, adding that she advises pet owners to avoid nontraditional formulations because it can't be known in advance if a pet might be susceptible.
There is a way for pet owners who don't want to switch from their nontraditional brand of pet food to check on heart health, said Dr. Joe Bartges, a professor of internal medicine, interventional radiology and nutrition at the Veterinary Medical Center at the University of Georgia.
"There are biomarkers that can look at whether the heart muscle has been damaged," Bartges said, adding that veterinarians can run a blood test that measures levels of a protein called BNP.
Cornell's Cohen advises owners to steer clear of any pet foods that have these listed in the top 10 ingredients:
Even with the news coverage of diet-related DCM, there are owners who are not familiar with the issue. Carter, who participates in a Facebook DCM group, recently heard from another golden retriever owner whose dog had died from the condition.
"Her 5-year-old golden retriever had died two months ago after being fed one of the diets linked to this disease," Carter said. "Her loss hit me hard, especially considering her dog's age and breed. I put my head down on my desk and cried."
This story originally appeared on NBCNews.Com.
This article was originally published on TODAY.Com
How Can Different Diets Combined With Salt Restriction Alleviate High Blood Pressure And Hypertension?
A recent Clinical Nutrition study conducted a clinical trial to compare the popular diets, namely, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet (MedDiet), in combination with a salt-restricting strategy for reducing high blood pressure (BP) and hypertension.
Study: DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial. Image Credit: Sea Wave/Shutterstock.Com Background Ineffective BP control strategies are a prominent risk factor for premature mortality and morbidity worldwide. An uncontrolled BP increases the risk of complications suh as cardiovascular events and chronic kidney disease.
People with grade 1 hypertension and low-moderate cardiovascular disease are recommended to intake less salt and adopt non-pharmaceutical interventions to manage hypertension. Recent meta-analyses of randomized controlled trials (RCTs) have correlated salt intake with BP level. Low salt intake can improve BP levels.
Besides salt intake, both DASH and MedDiet are associated with effective BP reduction in adults with or without hypertension. Both the diet types recommended a high intake of plant-based foods and a low intake of red and processed meat.
Compared to the DASH diet, the MedDiet is high in total fat due to the inclusion of olive oil. Therefore, for patients with high BP, the DASH diet has proved to be more effective than the MedDiet.
Although the American College of Cardiology/American Heart Association (ACC/AHA) recommended the DASH diet as a heart-healthy diet in 2017, it was contradicted by the European Society of Cardiology/European Society of Hypertension (ESC/ESH) in 2018. The ESC/ESH recommended the MedDiet to be a healthy diet that can be easily practiced for a prolonged period.
The DASH diet with salt restriction exhibited a higher BP reduction. However, it must be noted that this combining strategy is not commonly practiced. To date, no studies have indicated the effectiveness of MedDiet with salt restriction. Furthermore, there is a need for a comparative study to assess the effectiveness of the DASH diet and MedDiet in lowering BP.
About the studyThe current randomized, single-center, controlled, single-blinded study compared the effectiveness of the DASH diet and the MedDiet based on a three-month intervention period. A total of four parallel groups, i.E., control group (CG), salt restriction group (SRG), DASH diet combined with salt restriction group (DDG), and MedDiet combined with salt restriction group (MDG), were formed with a 1:1:1:1 allocation.
Participants (18 to 65 years of age) who visited the Hypertension Unit of the Hippokration General Hospital of Athens for the first time were selected for this study.
All participants had a high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg), grade 1 hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg), or low-moderate cardiovascular disease risk.
However, none of them were under antihypertensive drug treatment or had a history of major medical conditions. At baseline, BP was measured, fasting blood samples were collected, and ambulatory blood pressure monitoring (ABPM) was performed.
Study findingsA total of 240 participants were randomly assigned to one of the four trial groups. The four study groups did not differ in terms of demographic and clinical characteristics at baseline.
Furthermore, at baseline, ~48% of the study cohort had high normal BP, and ~51% had grade 1 hypertension. The mean baseline BP (systolic/diastolic) was 137/88 mmHg, and the baseline 24-hour ambulatory BP (systolic/diastolic) was 133/83.
The primary assessment after three months of intervention revealed that, except for CG, all other intervention groups exhibited improvement in systolic and diastolic pressure. Compared to SRG, both the DDG and the MDG exhibited a greater reduction in systolic BP.
Furthermore, compared to the DDG, the MDG revealed a greater reduction of systolic BP values. All intervention groups exhibited a significant reduction in diastolic BP. Both the DDG and the MDG intervention exhibited similar 24-hour ambulatory systolic and diastolic BP values.
In comparison to CG, all other intervention groups indicated marginal odds of hypertension. Among interventions, the DDG and MDG exhibited lower odds of hypertension, with 65% and 84% odds, respectively, compared to the SRG.
In relation to the baseline levels, the greatest reduction in office systolic BP was found in MDG and diastolic was found in the DDG.
ConclusionsIn sum, the MedDiet was found to be more effective in reducing office systolic BP compared to the DASH diet, while the DASH diet exhibited equal effectiveness for the reduction in office diastolic BP.
After three months of intervention, the DASH and the MedDiet exhibited similar 24-hour ambulatory systolic and diastolic BP values. Notably, dietary patterns combined with salt restriction exhibited the most effective result in BP improvement.
In the future, more studies are required to investigate the cardiovascular disease risk and other outcomes linked to MedDiet and the DASH diet combined with salt restriction. A longer clinical trial must be conducted to understand the effectiveness of each intervention better.
Comments
Post a Comment