Tag Archives: prevention

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?

 

Heart Health and Type 1 Diabetes

 

Diabetes plays such a role in heart disease that it is considered not only a risk factor but a coronary artery disease equivalent. Women who experience gestational diabetes have increased heart risk throughout their adult life. There a multiple presentations and forms of diabetes but broadly can be considered type 1 and type 2.

Fewer people have Type 1 Diabetes compared with Type 2 Diabetes, however in general Type 1 can present at much younger ages. I was diagnosed with type 1 diabetes at age 20 (also called “Juvenile diabetes” I was insulted to be diagnosed when I was no longer a juvenile – only to learn that the ‘juvenile’ terminology was no longer accurate, and yes, I did have T1D).

Recommendations for heart health and using lifestyle to reduce risk for heart disease applies if you have diabetes – and is even more important.

Heart Health and Type 1 Diabetes is a post for the organization Beyond Type 1 that outlines heart health and Type 1 Diabetes. Heart Health Docs followers will recognize a lot of the content and emphasis on heart healthy choices including the American Heart Association Life’s Simple 7

Take a few minutes this Labor Day weekend to check out The Beyond Type 1 website  ~ an excellent source of information covering nutrition, health, and stress management for anyone looking to improve their health, and is a great place to learn about type 1 diabetes specifically.

 

 

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

Are “Bad” Fats Still Bad? Some New Information

 

We often receive conflicting information on the role of dietary fats and heart risk. A new breadstudy released this month is attempting to clarify this link, since it is one of the largest studies ever conducted on dietary fats and overall long-term health risk. It was performed by the well-respected Harvard School of Public Health, and used a database of over 126,000 men and women followed for 32 years. These were healthcare workers who are in good health, and the dietary habits were followed closely with detailed questionnaires. Their rates of death over 32 years were then tracked carefully.

Here are some of the key findings:
1. Eating more saturated fat and trans-fats (“Bad” fats) was indeed associated with an increase in overall mortality (death rates).
2. Eating more polyunsaturated and mono unsaturated fats (“good” fats) did reduce the overall risk of death. For example, replacing just 5% of your total calories of bad fats with good (polyunsaturated) fats, would reduce the risk of death by 27%.
3. Simply replacing the bad fats with carbohydrates did not show any protective effect. (I call this the “Snackwell Cookie” effect)
4. In addition to lower heart and vascular disease, subjects  who ate more healthy fats also had a lower risk of dying from neurodegenerative and respiratory disease. So, a healthy diet may protect against a variety of chronic diseases.

Polyunsaturated fats contain essential fats your body can’t produce by itself, such as omega-6 and omega-3 fatty acids. Some of the best sources are nuts, seeds, fatty fish, and leafy greens. They are also found and vegetable oils such as canola, soybean, and safflower oil.  In this particular study, monounsaturated fats were also protective but less so than polyunsaturated fats. The most common example of a monounsaturated fat is olive oil.

Of course, this was a retrospective review, so the findings are not as powerful as a randomized study.  Nevertheless, the study appears to support the recommendation that we should reduce saturated fats in our diet, and emphasize polyunsaturated fats instead. We should also be careful not to increase our carbohydrate intake to compensate, emphasizing the role of total calories.  We still have a lot to learn regarding the optimal diet for disease prevention, but studies like this continue to shed light on the subject.

MORE INFORMATION:

This article from CNN Online has a very nice summary of the findings, along with an excellent summary of the various types of good and bad fat, and examples of each in the diet:   Good fats can cut risk of death by 27% @CNN

Here is a link to the scientific summary of the study:

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