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It is never too late to adopt a healthy diet to reduce heart attack risk

Robin Wulffson MD's picture
healthy diet, heart attack, myocardial infarction, cardiovascular disease

This time of year many of us blow our diet at a festive holiday meal. In addition, many Americans eat unhealthily much of the time. The result might be a heart attack, particularly among older individuals at high risk of cardiovascular disease (CVD) who are receiving effective drugs for secondary prevention. The CVD risk of an unhealthy diet was reported in a new study by an international team of researchers. Their findings were presented in the December 4 edition of the journal Circulation.

According to the American Heart Association, CVD is the number one cause of death in the United States. The researchers noted that diet quality is strongly related to CVD incidence; however, little is known about its impact on cardiovascular disease events in older people at high risk of CVD and receiving effective drugs for secondary prevention.

Therefore, they designed a study to assess the association between diet quality and CVD events in a large population of subjects from 40 nations with CVD or diabetes mellitus with end-organ damage (i.e., a previous heart attack or health issues associated with atherosclerosis) who were receiving medications that had proven benefit.

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The study group comprised 31,546 women and men (age: 66.5 ± 6.2 years) enrolled in two randomized trials: the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET); and the Telmisartan Randomized Assessment Study in ACEI Intolerant Subjects With Cardiovascular Disease (TRANSCEND). The investigators used two dietary indexes: the modified Alternative Healthy Eating Index; and the Diet Risk Score. The association between diet quality and the primary composite outcome of cardiovascular death, myocardial infarction (heart attack), stroke, or congestive heart failure was assessed. The findings were adjusted for age, sex, trial enrollment allocation, region, and other known confounders (information that could impact the validity of the results). During the 56-month follow-up, 5,190 cardiovascular events occurred. Individuals with the healthiest diets (those with the highest intakes of fruit, vegetables, whole grains, nuts, and a higher intake of fish relative to meat poultry and eggs)—were 35% less likely to die from a repeat myocardial infarction or stroke during the length of the study, compared with those with the least healthy diets. They also were 28% less likely to develop congestive heart failure, 14% less likely to have an additional heart attack and 19% less likely to have a stroke.

The authors concluded that a higher-quality diet was associated with a lower risk of recurrent CVD events among individuals 55 years of age or older with CVD or diabetes mellitus. They suggested that highlighting the importance of healthy eating by health professionals would substantially reduce CVD recurrence and save lives globally. The researchers also evaluated diet quality and the risk for other medical conditions such as cancer, fractures and non-heart related hospitalizations. They did not find any associations related to diet in regard to these factors.

Take home message:
Although it is common knowledge that a healthy diet reduces the risk of cardiovascular disease, this study notes that individuals with cardiovascular disease who are taking appropriate medication can have a longer and healthier life if they are on a healthy diet. Thus, it is never too late to adopt a healthy lifestyle.

Reference: Circulation

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Most scientific agencies are in agreement: Saturated animal fat and cholesterol do not do the heart any good. According to USDA figures, each day, the average American eats just 5 ounces of meat and chicken containing saturated fat and cholesterol, and 29.2 ounces of milk and dairy products (666 pounds per American) containing the same dangerous factors. A Survey of Mortality Rates and Food Consumption Statistics of 24 Countries quotes "Milk and milk products gave the highest correlation coefficient to heart disease, while sugar, animal proteins and animal fats came in second, third, and fourth, respectively! And Davies, in the Lancet quotes; "More patients who had suffered a myocardial infarction had elevated levels of antibodies against milk proteins than was found in a comparable group of patients without coronary heart disease." Finland ranks highest of all in milk consumption and mortality from heart disease." The Lancet, I, 1017-1020, 1979