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Acculturation from South Asian Lifestyle to Western Lifestyle Linked with Heart Disease Risk

Around the world, transitioning from a traditional diet with daily movement to a sedentary Western diet is linked with rising rates of chronic disease. In this study, researchers investigated the lifestyle factors that are associated with heart disease risk in South Asian adults. They found that moving from a traditional diet and lifestyle to one low in fruits and vegetables, low in physical activity, and high in alcohol and smoking is linked with a 2 to 3-fold higher risk of incident heart disease. “There’s a high recidivism in subjects who are placed on an eating plan different from their usual dietary patterns,” said Dr. Sikand, emphasizing the importance of culturally tailored diets. (Note that findings presented at meetings are considered preliminary until published in a peer-reviewed journal.)
Presentation at National Lipid Association Scientific Sessions. Miami, FL. May 16, 2019. (Sikand G)

Mediterranean Diet Linked with Improvements in Cardiodiabesity

“Cardiodiabesity” is an umbrella term which refers to the relationship between obesity, cardiovascular disease, metabolic syndrome, and type 2 diabetes. Researchers analyzed over 50 studies to answer several key questions about the impact of the Mediterranean diet on cardiodiabesity. The researchers found strong evidence that following the Mediterranean diet reduces obesity, blood pressure, and the risk of cardiovascular disease in healthy and at-risk people. They also found moderate evidence that the Mediterranean diet reduces the risk of developing metabolic syndrome and type 2 diabetes, and can reduce the symptoms of type 2 diabetes in diabetics.
Nutrients. 2019 Mar 18;11(3). pii: E655. doi: 10.3390/nu11030655. (Franquesa M. et al)

Different Saturated Fats May Have Different Impacts on Health

Replacing saturated fats, like those in butter, cheese, and red meat, with unsaturated fats, like those in walnuts, olive oil, and avocados, can help reduce risk of heart disease. But are all saturated fats created equal? To better assess this relationship, scientists analyzed the diets of 2 large groups of European adults (from Denmark & the U.K.) totaling more than 75,000 participants, and then monitored their health outcomes more than a decade later. In one of the groups (the Denmark group), saturated fats from meat were linked with a higher risk of a heart attack, but other sources of saturated fat were not significantly linked with heart attack risk in either direction. Scientists also noted that lauric acid and myristic acid (saturated fats found in foods like coconut oil) were also linked with lower heart attack risk in the Denmark group, but not the U.K. group. More research is needed to better understand how different foods might relate to heart attack risk.
International Journal of Cardiology.  2019 Mar 15;279:18-26. doi: 10.1016/j.ijcard.2018.10.064. (Praagman J et al.)

Mediterranean Diet Has Long History of Health Benefits

Mediterranean diet first rose to prominence in the 1950’s and since that time has become one of the most-studied diets in the world. In this study, researchers summarize the Mediterranean diet’s scientific history and key takeaways, including its benefits for weight loss and the prevention of heart disease and type II diabetes. The Mediterranean diet has also been linked with the possible prevention of certain types of cancer and neurodegenerative diseases such as Alzheimer’s. The authors note that the erosion of tradition threatens the Mediterranean diet in its place of birth, and that more populations could benefit from adopting a more Mediterranean inspired diet.
International Journal of Environmental Research and Public Health. 2019 Mar 15;16(6). pii:E942. doi: 10.3390/ijerph16060942. (Lăcătușu C-M et al.)

Small Amounts of Red and Processed Meat Linked with Cardiovascular Death

Seventh-Day Adventism is a religion which promotes a vegetarian diet and overall healthy lifestyle as a spiritual practice. In this study, researchers followed a cohort of over 90,000 Seventh-Day Adventists for an average of about 12 years and analyzed their consumption of red and processed meats. They found that participants who ate the most red and processed meat tended to be less physically active, were more likely to smoke tobacco and drink alcohol, and had a lower intake of fruits, vegetables, legumes, and whole grains than the participants who ate no meat at all. Compared to vegetarians, participants who ate red and processed meat were more likely to die of any cause and of cardiovascular disease. Notably, the participants who ate the most red and processed meat in this study (about 1.5 ounces per day) still have a relatively low consumption when compared to the average American diet (sometimes closer to 5 ounces per day). This suggests that even a low consumption of red and processed meats may have negative health effects.
Nutrients.  2019 Mar 14;11(3). pii: E622. doi: 10.3390/nu11030622. (Alshahrani SM et al)

Mediterranean Diet May Help Prevent Heart Disease

Cochrane reviews are some of the most rigorous reviews in scientific research. In this Cochrane review, researchers analyzed 30 existing randomized controlled trials (the “gold standard” of nutrition research) and 7 ongoing trials of the Mediterranean diet and its impact on heart disease risk. The study found small to moderate evidence for benefits of the Mediterranean diet for preventing heart disease, but note that more research is needed to better understand the benefits, particularly in patients who already have heart disease.
The Cochrane Database of Systematic Reviews. 2019 Mar 13;3:CD009825. doi: 10.1002/14651858.CD009825.pub3. (Rees K et al.)

Frequent Olive Oil Consumption May Be Linked with Making Blood Less Likely to Clot

Olive oil is a well-known heart healthy food, and new research sheds light on a potential explanation behind this benefit. In this study, researchers analyzed the eating habits of 63 obese but otherwise healthy adults, and also analyzed the platelet activity in their blood. (Platelets are the building blocks of blood clots when they stick together.) Those eating olive oil at least once per week had significantly lower platelet activation, indicating that their blood may be less likely to clot. (Note that findings presented at meetings are considered preliminary until published in a peer-reviewed journal.)
Presentation at American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions. Houston, TX. March 7, 2019 (Heffron SP et al.)

Whole Grains and Fiber Linked with Lower Risk of Many Diseases

Whole grains are one of the most popular food sources of fiber, and both whole grains and fiber are important for overall health. In this study, researchers analyzed data from more than 200 studies encompassing 4,635 participants to better understand fiber and whole grains’ relationship with disease prevention. Fiber was linked with a 15-30% lower risk of heart disease, stroke, type 2 diabetes, colorectal cancer, and death, with similar findings for whole grains. The researchers noted a dose-response relationship for both whole grains and fiber, indicating that those who eat the most may confer an even greater benefit.
The Lancet. 2019 Feb 02;393(10170):434-445. doi: 10.1016/S0140-6736(18)31809-9 (Reynolds A et al.)

Combining Statins with Mediterranean Diet Linked with Lower Risk of Death from Heart Disease

Statins are a type of cholesterol lowering medication often prescribed to patients with heart disease. To see how diet might impact the effectiveness of statins, researchers analyzed the eating habits and health outcomes of 1,180 older adults with heart disease for 8 years. Those most closely following a Mediterranean Diet were 30% less likely to die from heart disease over the study period. However, statins only reduced heart disease death risk when taken in combination with the Mediterranean diet. Furthermore, the patients taking statins in combination with a Mediterranean diet had a 50% lower risk of dying of heart disease than those just using one approach (diet or medicine). The researchers suspect that this synergistic effect may be due to the anti-inflammatory effects of the Mediterranean Diet. 
International Journal of Cardiology.  2019 Feb 1;276:248-254. doi: 10.1016/j.ijcard.2018.11.117. (Bonaccio M et al.)

Red Meat Linked with Risk Factor for Heart Disease

TMAO is a potentially dangerous metabolite linked with heart attacks and stroke, so researchers wonder how diet can impact the amount of TMAO that our bodies produce. In this study, researchers assigned 113 adults to a high-saturated fat or low-saturated fat diet for 4 weeks, with a washout period before switching to the other diet. Interestingly, saturated fat did not impact TMAO. However, eating lots of red meat (but not white meat or nonmeat) was linked with significantly higher levels of TMAO through 3 different mechanisms (nutrient density of TMA precursors, increased production from carnitine, and reduced TMAO excretion).
European Heart Journal. 2018 Dec 10. doi: 10.1093/eurheartj/ehy799. (Wang Z et al.)

Mediterranean Diet Linked with ¼ Lower Heart Disease Risk in Women

The Mediterranean diet is closely linked with heart health, and researchers want to learn more about the underlying mechanisms behind this connection. In this study researchers analyzed the diet and health outcomes of 25,994 women for 12 years. Those most closely following a Mediterranean diet were 28% less likely to develop heart disease than those not following a Mediterranean diet. Even those who were only moderately following a Mediterranean diet had a 23% lower risk of heart disease, indicating that even small lifestyle changes can have a meaningful impact on health. The researchers suspect that part of the heart health benefits may be related to lower inflammation, as women most closely following the Mediterranean diet had significantly lower levels of biomarkers of inflammation. Other factors shown to affect the relationship between the Mediterranean diet and heart health are the Mediterranean diet’s links to blood sugar management, BMI, blood pressure, and cholesterol.
JAMA Network Open. 2018 Dec 7;1(8):e185708. doi:10.1001/jamanetworkopen.2018.5708 (Ahmad S et al.)

Whole Grains Linked with Lower Cholesterol

To better understand whole grains’ relationship with heart health, New Zealand’s Heart Foundation analyzed 19 meta analyses encompassing thousands of participants, for their September 2018 report entitled “Whole Grains and the Heart.” The authors conclude that “observational research suggests three [servings] of whole grains per day are associated with heart health benefits, and there are likely to be additional benefits with higher intakes. Intervention studies on risk factors are less compelling but show most consistent evidence of benefits for a small reduction in total and LDL cholesterol, especially in relation to oats and barley, and possibly improved [glycemic] control.”
Heart Foundation. 2018 Sept. (Gorton D et al.)

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