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Mediterranean Diet Linked with Less Rehospitalization in Elderly Heart Failure Patients

The Mediterranean diet is well known for its role in preventing heart disease, but researchers wonder if this protective effect translates to patients who already have heart failure. In a Spanish study of 991 elderly patients admitted to the emergency room with acute heart failure, those following a Mediterranean diet were 24% less likely to be hospitalized one year later. After 2 years, those following a Mediterranean diet appeared to be less likely to die, but the results were not statistically significant, especially after adjusting for age and other health conditions.
JACC Heart Failure. 2017 Nov 27. pii: S2213-1779(17)30683-2. (Miro O et al.)

Whole Grain Wheat and Rye Both Linked with Gut Health

Whole grains are a popular healthy choice, but between whole wheat and whole rye, does it matter what you choose? Scientists put these grains to the test, randomly assigning 70 overweight but otherwise healthy, middle-aged adults to a 6-week diet replacing all of their grain foods with whole wheat, whole rye, or refined wheat. There were no significant differences between the whole wheat and whole rye groups. Despite seeing no significant changes to the composition of the gut microbiome, the refined wheat group saw a greater drop in fecal butyrate (compounds associated with better health). The whole grain groups were less likely to feel bloated and more likely to have regular stools, but also more likely to pass gas. The authors conclude that “whole-grain foods have the potential for maintaining or improving some subjective and functional markers of gut health compared to refined grain foods.”
Journal of Nutrition. 2017 Nov;147(11):2067-2075. (Vuholm S et al.)

Heart-Healthy, Traditional Mediterranean Diets Can Work Anywhere if Properly Followed

The Mediterranean Diet gets lots of buzz, but do you know what it really means to eat like a Mediterranean? In a meta-analysis of 27 studies, researchers estimate that every 2-point increase in Mediterranean Diet Score (0-9 scale) is related to an 11% lower risk of heart disease. Additionally, the researchers also analyzed the consistency between Mediterranean Diet Scores in different studies, and clarified the importance of using a standard definition of a Mediterranean diet, which emphasizes “vegetables, fruits, nuts, legumes, and mainly unrefined, minimally processed cereals; an abundant fat intake from virgin olive oil… a moderate consumption of fish and shellfish, a low consumption of meat… the consumption of wine during meals… and fermented dairy products.” In order to successfully transfer Mediterranean diets outside of the Mediterranean, the researchers also note the importance of following the Mediterranean Diet eating patterns (such as drinking a moderate amount of wine with meals throughout the week, rather than binge drinking on weekends) and choosing traditional foods (such as olive oil and beans) rather than untraditional foods (such as margarine and tofu).
Nutrients. 2017 Nov 8;9(11). (Martinez-Gonalez et al.)

Whole Grains Linked with Weight Loss, Less Inflammation

Why worry about calorie counting when whole grains can keep you satiated and help you lose weight? Researchers randomly assigned 50 Danish adults to a whole grain or refined grain diet for 8 weeks each, with a 6-week washout period in between. All of the participants were overweight, obese or had large waist sizes, and also had slightly high levels of blood sugar, cholesterol, or blood pressure before the study. The participants lost significantly more weight on the whole grain diet (- 0.4 pounds) compared to the refined grain diet (+ 2 pounds). This is likely because people naturally ate fewer calories on the whole grain diet, as whole grains are more satiating. Additionally, the whole grain diet (especially rye foods) significantly lowered inflammation (measured by IL-6 and CRP). However, the researchers noted no significant changes in insulin sensitivity (an indicator of how well your body is able to manage blood sugar), or the gut microbiome over the 8-week study.
Gut. 2017 Nov 1. pii: gutjnl-2017-314786. [Epub ahead of print.] (Roager HM et al.)  

Mediterranean Diet Linked with Lower Risk of Blocked Arteries

As a way of testing if people might have blocked arteries (atherosclerosis), doctors compare blood pressure readings between your arm and your ankle in a test called the ankle-brachial index (ABI). To see how eating a Mediterranean Diet relates to these results, researchers analyzed the eating patterns and ABI of 425 pre-menopausal, middle-aged women in Italy. Researchers estimated that those most closely following a Mediterranean Diet were 10% less likely to develop peripheral arterial disease compared with those not following a Mediterranean Diet.
Nutrition, Metabolism, and Cardiovascular Diseases.  2017 Oct 3. pii: S0939-4753(17)30226-0. (Mattoidi AV et al.)

Eating Fish Linked with 40% Lower Risk of Heart Disease

Fish is well recognized for its role in a heart-healthy diet. To learn more about how fish eating relates to heart disease risk in a Mediterranean population, scientists analyzed the eating patterns and health outcomes of nearly 21,000 Italian adults. Those eating fish at least 4 times per week were 40% less likely to develop coronary heart disease than those eating fish fewer than 2 times per week. This relationship is primarily driven by fatty fish, like salmon, trout, herring, mackerel, and canned fish. Strokes were also studied, but the trend toward lower stroke risk in frequent fish eaters was not statistically significant.
Nutrition, Metabolism, and Cardiovascular Diseases. 2017 Aug 23. pii: S0939-4753(17)30198-9. (Bonaccio M et al.)

Healthy Plant-Based Diets Linked with Lower Risk of Coronary Heart Disease

Wholesome plant foods are the foundation of a healthy diet, but not all “vegetarian” foods are equally nutritious. To see how different variations of plant-based diets relate to the risk of developing coronary heart disease (when plaque builds and hardens in the heart’s major blood vessels and decreases blood flow), researchers analyzed data detailing what more than 200,000 people ate over 20 years and separated people into three versions of plant based diets: overall plant-based diet (includes all plant foods and some animal foods), healthful plant-based diet (includes healthy plant foods like whole grains, fruits, and vegetables), and unhealthful plant-based diet (includes sugar-sweetened drinks and refined grains). Not surprisingly, they found that the second choice – eating fewer animal foods and more healthy plant foods – was linked with a lower risk of developing coronary heart disease, while eating more animal foods and more unhealthy plant foods was linked with an increased chance of developing coronary heart disease.
Journal of the American College of Cardiology. 2017 July; 70(4):411-422. (Satija et al.)

Butter isn’t “back,” according to the American Heart Association

In order to clear up confusion about how different dietary fats relate to heart health, the American Heart Association published a Presidential Advisory on Dietary Fats and Cardiovascular Disease. In this paper, the researchers reviewed randomized controlled trials (the gold standard of nutrition research) as well as prospective observational studies (following large groups of people over long periods of time and noting their health outcomes). After reviewing all of the evidence, they concluded that replacing saturated fat (the types of fats found in red meat, butter, and milk) with polyunsaturated fat (found in fish, nuts, and seeds) can lower the risk of heart disease by 30%, which is on par with what cholesterol lowering medications can achieve. Similarly, they found that eating more monounsaturated fat (found in avocados, olive oil, and canola oil), more polyunsaturated fat, and less saturated fat is linked with lower rates of heart disease. Saturated fat is also linked with higher rates of “bad cholesterol” (LDL), which is thought to build up in artery walls and pose a risk for heart disease. These findings are in line with healthy dietary patterns around the world, including the Mediterranean diet.
Circulation. 2017 Jun 15. [Epub ahead of print.] (Sacks FM et al.)

Mediterranean Diet Is Linked with Specific Patterns in Gut Microbiota

Although the science is still young, researchers are finding that the foods we eat may influence the bacteria that inhabit our gut. To see how the Mediterranean Diet relates to the gut microbiome, researchers analyzed the diet and gut microbiome of 120 Greek adults. Participants most closely following the Mediterranean diet had lower E.coli levels and a higher bifidobacteria: E. coli ratio, among other favorable microbiome characteristics.
British Journal of Nutrition. 2017 June 5;117(12):1645-1655. (Mitsou EK et al.) 

Pasta Meals Linked with Better Blood Sugar Response

Many are surprised to learn that pasta has a low glycemic index, meaning that it doesn’t spike your blood sugar as much as some other carbohydrate foods, like bread or potatoes. To see how pasta meals relate to health in a broader context, researchers analyzed 18 studies comparing the effects of pasta meals to other types of meals. They found that pasta meals are linked with a lower post-meal blood sugar response than bread- or potato-based meals. However, more research is needed to study how different types of meals relate to cardio-metabolic disease.
Nutrition, Metabolism, and Cardiovascular Diseases. 2017 Jul 18. pii: S0939-4753(17)30160-6. (Huang M et al.)

Gluten Not Related to Heart Disease, but Avoiding Whole Grains Is

Unless you have celiac disease, you might want to rethink that gluten-free diet. In a study of more than 100,000 US adults without celiac disease, followed for more than 25 years, researchers found that eating gluten was not related to heart disease risk. In fact, the researchers caution that avoiding gluten may result in eating fewer whole grain foods, which may in turn pose a risk for heart disease.
BMJ. 2017 May 2;357:j1892. (Lebwohl B et al.)

Moderate Alcohol Intake Linked with Lower Risk of Heart Disease

In the UK, moderate alcohol intake is defined by up to 3 drinks per day for men and up to two drinks per day for women. To see how drinking alcohol relates to heart disease risk, British researchers analyzed the drinking habits and health outcomes of nearly 2 million adults (although they did not differentiate between beer, wine, and other alcoholic beverages). They found that, compared to moderate drinking, both nondrinkers and heavy drinkers (exceeding the guidelines described above) were significantly more likely to suffer from heart failure, stroke, and death from heart disease, among other (but not all) heart problems. The scientists caution that “there are safer and more effective ways of reducing cardiovascular risk,” than taking up drinking (such as diet, exercise, and quitting smoking), and suggest that “a more nuanced approach to the role of alcohol in prevention of cardiovascular disease is necessary.”
BMJ. 2017 Mar 22;356:j909. (Bell S et al.)

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