Tag Archives: heart

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.

 

An Update on New Research – Straight from the Source!

IMG_8348rt5x7bwThere is always plenty of research being conducted on heart disease prevention, but this week I decided to go straight to the source. This week I will be blogging directly from the Cardiometabolic Health Congress in Boston – a collection of presentations on recent concepts and new research in the treatment of conditions like high blood pressure, high cholesterol and diabetes. The goal? To prevent heart disease and stroke.

Here are some highlights from the first day:

High Cholesterol: The big news in cholesterol treatment is the development of a new class of potent drugs, PCS-K9 inhibitors, (Which I previously reported on here) which are different from statins – they lower cholesterol potently, but must be given by injection. For now, they are reserved for patients with seriously elevated levels while taking statins – or those intolerant of statins.

While statins are very effective in patients with a history of heart disease, many patients who take them have never had cardiovascular disease – they were prescribed purely for prevention. Many people given statins are actually at low long term risk – and the statin may not impact their risk further. Recent research shows that we can refine which patients benefit by using a test to look for early evidence of plaque buildup in the arteries. This test, called a coronary calcium scan (or heart scan) is cheap and quick, and can clarify which patients really will benefit from a statin.  Here is a recent article from the New York TImes with more details.

Obesity: Anyone who has tried to lose weight know the frustration of seeing the weight return over time. We often attribute this to poor will power, but research now shows that certain hormones are activated that actually “stimulate” the body to gain weight – like a weight “thermostat” that tries to return to a prior setting. New research is trying to interrupt this cycle and allow weight to stay off.

Research also shows that there are different “types” of obesity – many people consider themselves overweight, but are otherwise very healthy – normal blood pressure, blood sugars, and cholesterol. In others, their weight leads to chronic issues and eventual complications. So always think of your weight in the context of your overall health.

Finally, when we decide to eat something, we assume we are doing so in response to feeling “hungry”. But research show that we often eat in response to other cues – sights and smells, emotional states, and availability of food. (A great example of “mindless” eating is chomping on popcorn while we are engrossed with a movie) So if you struggle with willpower, try to limit these non-hunger “cues” – remove unhealthy food from the house, and try to steer clear of temptations as you go about your day.

Tomorrow, we will hear about new research into high blood pressure and diabetes. (As always – these are general concepts – only your doctor can address your specific health issues).

Is your Heart older than You? Find out your “Heart Age”

Grewal Kanny MD 2x3 webI decided to spend my birthday figuring out my age. Not my actual age, which is painfully obvious, but my “Heart Age”. This is a new online calculator (featured in the Wall Street Journal this week) created by researchers in the UK, which uses existing data regarding the prediction of future cardiovascular risk (from the Framingham database, which is the most comprehensive set of data available). It has been reformatted into an algorithm that compares your true age with your estimated cardiovascular age, as a general way to look at your overall cardiovascular health.   To use the calculator, you need to know:

– your true age, sex, height and weight

-a recent total cholesterol and HDL if available

-a recent blood pressure reading

-your family medical history

Of course, there are several limitations to a simple calculator like this – it doesn’t take into account any symptoms you may have, or the duration or severity of risk factors. And the database from which it is drawn was created predominantly from Caucasian Americans, so it may not directly predict risk for other ethnic groups (for example South Asians, whose risk may be higher, or based on different weighting of factors). But it is a nice snapshot of your CV health in a format that is easy to understand.

So how did I do? Well, fortunately my Heart Age came out less than my actual age – but not by much. (Luckily, I have 365 days to make some progress!) Give it a try yourself:

Here is a link to the Heart Age calculator.

If your heart age is older than your real age, don’t dismay (the average result is 6 years older than real age!), but do look back at the questions – and notice how dropping your blood pressure, cholesterol, or waist size has a positive impact. We can’t change our age or family history (and generally not our sex), but lifestyle changes can go a long way to reduce our risk. So click here to learn about the best medication for heart disease – a therapy that reduces blood pressure and cholesterol and shrinks our waist size as well!

For more information see our articles on heart healthly diet and heart prevention in women.

Here is an informative video interview with the creator, from the WSJ: http://live.wsj.com/video/how-old-is-your-heart/A280BEEC-4649-4472-8223-65856B0FB3A5.html

Which Supplements Improve Wellness and Prevent Heart Disease?

Grewal Kanny MD 2x3 web

Those of us who treat heart disease deal with controversies on a daily basis; but I am not sure that any topic provokes more passion and controversy than a discussion about the use of supplements for the treatment and prevention of cardiovascular (and other) disease.   As medical doctors, we are trained to promote therapies grounded in ‘evidence” – that is, clinical trials and investigation. Unfortunately, most supplements and minerals have never been studied as thoroughly as drugs, so the “evidence” either for or against their use is lacking. Confusing this picture is that the proponents of supplement use may have an economic bias for their use, or their preference is based on their personal experience with a limited number of patients.

I am not a pharmacologist or nutritionist, but I do have an immense interest in any and all therapies that can improve my patients’ long-term health. Unfortunately, there is just not the evidence to recommend any specific supplement for the long-term prevention of cardiovascular disease, or any disease or complication for that matter. The preponderance of evidence suggests that eating a healthy and balanced diet, and of course improving lifestyle through weight control and exercise, is far more important than the potential effect of any specific supplement. This is even the case for a general multivitamin. This editorial article, which was just published in the last few months, summarizes the largest analysis to date of all the major research involving supplements in healthy patients. It summarizes a new analysis in over 100,000 subjects, and reaches the conclusion that none of the studied supplements can clearly prevent chronic disease. Fortunately very few of them are harmful as well (the exceptions are B-carotene and possibly Vitamin E, which may cause cancer).  Here is a quote from the authors (including the Johns Hopkins School of Public Health):

In conclusion, β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful. Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases. Although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe that the case is closed— supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough.

For this reason, I do not recommend the routine use of supplements by any of my patients, including a daily multivitamin; but I don’t discourage their use, unless a specific interaction is seen that could be harmful. Certainly, for patients with a specific chronic condition, it is worth looking for nutritional deficiency that can contribute but that can only be done by your physician or care provider. Here is some information about specific supplements:

Folate, Vitamin B6, and B12:  A well done study recently showed that these agents did not prevent vascular disease or cancer.

Fish Oil (omega-3 fatty acids): Here is our video which addresses the potential role of Fish Oil in prevention of heart disease.

Vitamin D: Vitamin D deficiency, diagnosed by a low blood level, is a potentially serious condition that benefits from replacement therapy. For those without a true deficiency, there does not seem to be a benefit to taking supplemental doses. Here is a recent article from USA Today which references a recent large study which pooled the results from 40 earlier studies. The conclusion is that Vitamin D supplementation does not seem to prevent chronic disease, except in those with a true deficiency documented by a blood test.

Selenium: The conclusion form the lead researcher of a recent study: “At this time, we cannot support using selenium supplements as a means of preventing cardiovascular disease in healthy people”.

We will address other specific supplements in future posts. In the meantime, consider skipping some (or all) of those supplements,  and instead focus on daily activity (see article here)  and a heart healthy diet (see article here). As always, we appreciate your comments and are happy to provide references.

Sudden Death in Athletes

Sudden death is always tragic, but even more so when it strikes a healthy teenager or young adult. There are steps we can take to understand risk in our youngsters and minimize the risk of this devastating event.

Here is our recent post on the OhioHealth website regarding sudden death in young athletes.

Also, here is a 10 minute video “curbside consult”, featuring Dr. Grewal,  courtesy of the Columbus Medical Association:

Recently, Ellie Merritt from NBC-4 interviewed me for her story on the sudden loss of an area teenager:   Mom Asks For Answers After Westerville Basketball Player’s Death