Category Archives: diet

Does diet advice drive you nuts? Maybe it should drive you TO nuts. . . .

IMG_8348rt5x7bwWe have known for a while that nuts are a natural source of good fats, vitamins, and healthy minerals.  Doctors and other health experts (including the HeartHealth Docs) have recommended nuts as part of a balanced diet for some time, and they are an important part of the Mediterranean diet, which seems to have a lot of heart healthy benefits.

But a new study, which you may have seen reported in the media, is the most comprehensive to date to look specifically at the link between nuts and heart prevention. The researchers analyzed data from 3 very large population health studies, including over 200,000 healthy adults, who were followed for up to 30 years to look at incidence of heart disease and stroke. What did they find?

1. Participants who consumed at least 5 servings of nuts weekly had about a 14% lower risk of heart disease than those who never ate nuts.
2. The link was similar for those who ate peanuts, tree nuts, or walnuts.
3. Surprisingly, there was a preventive benefit for heart disease but less so for stroke (with exception of peanuts and walnuts, which did have a slight positive effect).
4. Other not products, such as peanut butter, did not seem to have a protective effect.

Like a lot of population studies, this one was retrospective, so it did not prove that there is a direct link between nut intake and reduced disease. And the groups studied were not ethnically diverse. But it was carefully performed and in a very large population, so it is the best evidence so far that nuts are part of a healthy prevention diet.

Take away messages:
1. 1-5 servings of nuts weekly can be an important component of a preventive diet, especially for those who have, or are at risk for, heart and vascular disease.
2. All type of notes seem to be beneficial, even peanuts which are technically a legume.

3. Because nuts have a lot of calories, portion sizes important.  A serving of nuts is 1 ounce, which is about 28 peanuts, or 23 almonds.

4. Processed products such as peanut butter do not seem to have the same beneficial effect.

So find ways to incorporate whole nuts into your diet, but watch the portions!

Here is a link to more information about the study.

Here is more information from our site regarding diet and prevention.

Here are examples of a single serving of almonds:

Nut portions

 

 

 

 

Omega-3’s? Vitamin D? Vitamins? Which can prevent heart disease?

IMG_8348rt5x7bwWith heart disease continuing to be a leading cause of death throughout the world, researchers continue to look at how diet, supplements and other habits can impact the development of heart disease. Here is a rundown of some new studies that continue to shed light on how to prevent (or in some cases, not prevent) heart disease:

As most doctors have suspected for a while, vitamin D seems to have minimal effect on your heart and circulation system. This new study seems to confirm that fact.  Certainly, people with a severe deficiency should have replacement therapy, but routine use does not appear to have a significant preventive benefit.

The news with multivitamins is similar. We have suspected this for a while (see our prior article on the role of supplements) but now a large study on thousands of patients (in this case, limited to men) seems to confirm that routine multivitamin use really does not prevent future heart disease. This does not exclude other benefits, but reinforces our recommendation that multivitamins are probably not needed for those with a well-rounded diet.

How about fish oil? Here is a link to a nice updated article addressing which patients may benefit from omega-3 fatty acids. Despite high hopes, no studies have really shown a broad benefit to most healthy adults. But those with specific conditions may benefit.

These studies reinforce the Heart Health Doctors’ dietary advice – eat a balanced diet low in processed foods, unnecessary carbs (especially wheat-based) and saturated fats, and watch the total calories. As always, you should consult with your health provider about what specific diet is best for your health, and your medical conditions.

Here are our earlier articles on diet, supplements and heart disease:

Which Supplements Improve Wellness and Prevent Heart Disease?

Heart Healthy Diet – 10 eating tips

Do Healthy Adults benefit from Fish Oil?

 

Diet and Heart Disease – What Does the Science Say About What to Eat?

IMG_8348rt5x7bwIt is so hard to keep up with research on diet and disease prevention, especially with so many conflicting reports in the media. To try to sort through this, some researchers looked comprehensively at all of the high quality research available about diet and prevention of heart disease. They put together this nice summary table showing which foods show evidence of harm, which show evidence of benefit, and which are inconclusive.
It is important to remember that this is addressing heart disease specifically, not general health or general disease prevention.  And they limited their conclusions to the most thorough studies of heart disease outcomes.  For example, I think a diet which is low in wheat-based carbohydrates can be very beneficial for maintaining weight and preventing long-term health complications.
If you, or a family member, suffers from chronic heart disease, this table is a good starting point for a discussion with your physician and other health providers about the optimal diet to prevent future heart issues.

 

ACC food guide

Here are more of our articles on Nutrition and Heart Prevention.

You Really Are (and might die from) What You Eat (. . .or Don’t Eat)!

IMG_8348rt5x7bwMost of us understand that there is a link between what we eat and our health – but how strong, and how important, is that connection? Heart and circulatory disease is the number one killer of American adults, and we know that certain dietary behaviors can either promote, or reduce, health consequences.

But a new study  just released, shows just how strong that association is between diet and heart disease. These researchers looked at all of the important studies of specific food types and disease associations, then compared this to national surveys of Americans’ eating habits. They then estimated what proportion was due these various dietary habits.

Overeating, or not eating enough, of the 10 foods and nutrients contributes to nearly half of U.S. deaths from heart and circulatory disease, the study suggests.bread

“Good” foods that were under-eaten include: nuts and seeds, seafood rich in omega-3 fats including salmon and sardines; fruits and vegetables; and whole grains.

“Bad” foods or nutrients that were over-eaten include salt and salty foods; processed meats including bacon, bologna and hot dogs; red meat including steaks and hamburgers; and sugary drinks.

Of course, this was a study of populations, and most of us are most concerned about our personal habits and risk of disease (remember, only your doctor or health care provider can give your specific advice about your health care). And most importantly, the fact that certain dietary habits are “associated” with bad health, doesn’t mean those foods “cause” bad health.   But this is an interesting study that helps quantify the most important targets for change in our diet.  (click here to read  the full study)

For more information on Heart Health and Diet, see our overview article here.

 

#GoRedCbus ~ When should you learn about Heart Failure?

BW ARA labcoatThe American Heart Association’s Go Red for Women event February 23, 2017 gave Columbus information about Heart Health for Women, and provided opportunity to support AHA in advocacy, research, and education.

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Left – right, JS, Dr. Albers, Dr. Basuray

Dr Anup Basuray (photo) presented a breakout session on a complex topic. The name Heart Failure does not in fact mean a heart has stopped working (my engineer/math husband is one of many who question the name Heart Failure – but this has been and remains our wording). The term is broad covering symptoms that occur when the heart is not fully functioning – leading to symptoms including shortness of breath, leg swelling, abdominal swelling, fatigue, and/or weight gain or loss. In his presentation, Prevent. Treat. Recover. : Transforming Heart Failure into a Success Story Dr. Basuray highlighted examples of young women patients he has treated. His case presentations illustrated the different ways people get heart failure; some specific to women, for example in the case of problems associated with pregnancy.

Heart Failure is diverse in cause, outcomes, and treatment. The slide here shows ~ 10 causes of Heart Failure, more recently identified is history of cancer treatment, and also included is ‘unknown‘ or doctor-speak, idiopathic. Heart valve disease, genetics (inherited causes), high blood pressure, drugs and alcohol, infection, coronary artery disease, pregnancy related, and irregular heart rate/rhythm can all be causes of Heart Failure.

Heart Failure results in fluid retention by the kidneys, a problem that is worse with high sodium diet. Western diets have high sodium – top sources are Breads and rolls, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, SNACKS. Reading labels and being aware of sodium is key to heart health in general and to limiting fluid retention in Heart Failure in particular. Knowledge is power when considering what we eat – see here https://hearthealthdocs.com/heart-healthy-diet/  , and for surprising sources of salt https://hearthealthdocs.com/2016/06/08/surprise-sources-of-salt-in-your-diet/

Dr. Basuray addressed the power of prevention and how to stay healthy by knowing the following KEY modifiable risk factors for heart failure

  • High blood pressure
  • Diabetes
  • Obesity
  • High cholesterol

Know your numbers

  • Blood pressure, cholesterol, diabetes (blood glucose) screen
  • Every 4-6 years, as early as age 20

2013 AHA/ACC Heart Failure Guidelines 

So when should you learn about Heart Failure? Now is good. Same with choosing to live a heart healthier life.

Heart Health Docs recommended resources:

https://www.cardiosmart.org/Heart-Conditions/Heart-Failure

Who Benefits from Fish, or Fish Oil? Some New Info on the Link to Heart Disease

IMG_8348rt5x7bwWhile we have known for some time about the potential benefits of fish in the diet, the specific role of supplements containing the beneficial component, omega-3 fatty acids, has been less clear, due to inconsistent results from various studies.

Fortunately, a new study released this month has clarified the link between supplementation with omega-3 fatty acids and the development of heart disease. This was actually a meta-analysis, meaning it summarized the data from multiple previous studies, in a manner that yields more information than the individual studies themselves. This was a very thorough analysis, specifically looking at the best quality studies (called randomized trials), and specifically looking at the useful component of omega-3 fatty acids, EPA and DHA. Moreover, the researchers were focused specifically on heart and circulatory complications.

What did they find? The intake of omega-3 fatty acids, either from food or supplements,fish-oil reduced the risk of heart disease by 6%. This reduction is mild, and was actually insignificant, but there was a significant decrease specifically patients who started out with high triglyceride levels (> 150 mg/dL) or LDL cholesterol (> 130 mg/dL). When the researchers included additional nonrandomized studies, the reduction in heart disease was 18%. Another important conclusion was that there does not appear to be any harmful effect of supplementation.

So what can we conclude?
First, supplementation with 1 g of omega-3 fatty acids daily, either from food or supplements, appears to be mildly beneficial in preventing heart and circulatory disease.
Second, the majority of the benefit is in patients who start out with elevation of triglyceride or LDL cholesterol. Previous studies (such as this) have shown that otherwise healthy patients derive minimal or no benefit from fish oil supplementation.
Third, there does not appear to be evidence of harm at this level of supplementation.

Also of note, more detailed studies are ongoing to determine the optimal level of supplementation and specific patients. Finally, keep in mind that there are other potential benefits of fish oil supplementation unrelated to heart disease, so if supplementation makes you feel better or healthier, it may be reasonable.  As always you should discuss your specific health situation with your doctor before considering any supplement or other therapy.

 

For more information, here as a video I recorded last year for the video blogging site Vidoyen.com, who asked me, Do Fish Oil supplements prevent heart disease? Here is a link to my 3 minute reply.

Reference to original article:

Alexander D, Miller P, Van Elswyk M, et al. A meta-analysis of randomized trials and prospective cohort studies of eicosapentaenoic and docosahexaenoic long chain omega-3 fatty acids and coronary heart disease risk. Mayo Clin Proc 2017;92:15-29

Can a “Good” or “Bad” Lifestyle Overcome “Good” or “Bad” Genes for Heart Disease?

IMG_8348rt5x7bwThe genes we inherit from our parents are important -not just for our looks or height, but also for our risk of chronic disease.  In particular, we know a portion of heart disease can be determined by our genetic risk. At the same time, there is a lot of evidence that our lifestyle can either promote or reduce our risk of illness and/or overall longevity. Heart specialists have long wondered about the relative importance of healthy lifestyle and our predetermined genetic risk. A new study has shed some light on this important topic and given us some guidance on prevention of heart disease (Click here for a link to the full article).

In a nutshell, the researchers found that “bad” genes can double our lifetime risk of heart disease, but a “good” lifestyle can cut the risk in half.  Meanwhile, a “bad” lifestyle can erase close to half of the benefits of “good” genes.

Remember, simply having a history of heart problems in her family does not mean you are doomed to develop heart problems yourself. Heart disease is extremely common and is actually the #1 killer of adult men and women in the US.  Certainly, if multiple family members have succumbed to heart disease, especially at a relatively young age, then suspicion would be raised about a genetic predisposition. To get specific advice regarding your personal heart risk, you should discuss your specific situation with your doctor or health care provider.

So, while we cannot do much about the looks and height we inherit from our parents, a “heart healthy” lifestyle can certainly undue a lot of the heart risk!

Please follow these links to our other articles for information on heart healthy diet, overview of heart prevention, and the role of exercise.