The health benefits of eating extra fruits and vegetables are well established: for years, children have been told that an apple a day will keep the doctor away.
But now, scientists have identified a diet promoting a much wider range of foods, including fish, poultry and nuts, that they say is much more effective at cutting the risk of heart attacks.
The Dash (Dietary Approaches to Stop Hypertension) dieting plan reduces the chances of suffering from heart disease by 18 per cent over 10 years, compared with an average American diet. People who simply up their consumption of fruits and vegetables see an 11 per cent decreased risk, a study shows.
Recommended by the American Heart Association, Dash – Dietary Approaches to Stop Hypertension – lowers blood pressure and cuts levels of artery- clogging cholesterol.
Rich in fruit and vegetables, it also focuses on low-fat dairy products, whole grains, nuts, poultry and fish. Fats, sweets, red meat and sugary drinks should be avoided.
Dr Marilyn Glenville, a leading nutritionist, said: ‘Cholesterol causes a problem when it oxidises in the body and the antioxidants in fruits and vegetables prevent that from happening.
People should try to eat as many different colours as possible: they need to eat a rainbow.’ Whole grains, said Dr Glenville, provide fibre, which ‘mixes with the cholesterol in the intestine, helping to push it out of the body’.
Poultry, fish and nuts are good sources of protein, but lower in saturated fats than red meat.
The dash diet
Dr Glenville told the Independent-They also contain more omega 3, which controls inflammation of the arteries and, in some cases, of the heart itself.
‘That inflammation, along with cholesterol, is often the cause of heart disease. Sugary drinks and sweets have the opposite effect.’
A team of US researchers tested the Dash diet’s worth on men and women deemed to be at risk of high blood pressure.
One group ate a ‘normal’ American diet of foods high in fat and low in minerals, another ate similar food but also got their five servings of fruit and vegetables a day.
A third followed the Dash diet and had all their meals prepared for them for two months.
Blood pressure and cholesterol were measured at the start and end of the study and used to calculate individual risk of heart problems over the next ten years.
Regularly eating five fruit and veg a day would cut the risk by 7 per cent.
The Dash diet, however, was more than twice as good.
How the diet works…
Fruits and vegetables
Antioxidants from fruit and vegetables are the diet’s most important components. Cholesterol becomes a problem when it oxidises, but this can be stemmed by antioxidants. The pigments in fruits carry different antioxidants.
Low-fat dairy foods
The diet maximises the positive effects of fruits and vegetables, and limits the damage caused by saturated fats in dairy foods by eating low-fat versions.
Whole grains
When the fibre from whole grains is stripped away from foods, they are digested more quickly, causing a rise in blood glucose and bad cholesterol.
Poultry, fish and nuts versus red meat and sugary foods
The former do not have as much saturated fat as the latter and contain Omega-3. Sugar enters the bloodstream quickly, causing high blood glucose and high cholesterol.
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September 19th, 2010 at 2:29 pm
DIETING can raise the risk of cancer, diabetes and other fatal diseases by releasing toxins into the body, alarming research has found.
The study reveals how weight loss allows harmful pollutants, normally stored in body fat, to circulate in the bloodstream.
Scientists from the US, Norway and South Korea studied 1,099 people over 40, tracking their weight for 10 years, with frequent blood tests for seven of the most dangerous pollutants.
These included DDE, a pesticide linked with breast cancer, Alzheimer’s and Parkinson’s disease, and PCB169, a toxin linked with damage to the brain and nervous system. They found higher blood levels of these chemicals in people who had lost weight.
September 19th, 2010 at 2:30 pm
Kidney stones have been on the rise in the U.S. for the past 30 years. A new study has found that a diet known to reduce blood pressure may help.
The “dash diet” is one that is high in fruits, vegetables, nuts and dairy products. It’s also low in red meat and sugary drinks.
This new study has found that the combination of foods may help reduce the risk of kidney stones.
Researchers say people who followed the dash diet had higher concentrations of citrate an important salt that prevents calcium stones.
It’s believed the lower rate of kidney stones could be due to higher water content in dash-type foods.
September 20th, 2010 at 6:16 pm
New research has concluded that the DASH eating plan, known to reduce blood pressure and bad cholesterol, also reduces the 10-year risk of heart attack, especially among African-Americans.
The DASH eating plan emphasizes fruits, vegetables and low-fat dairy products as well as whole grains, poultry, fish and nuts.
The plan also calls for a reduction in fats, red meat, sweets, and sugar-containing beverages. The U.S. government and American Heart Association recommend it.
The study researchers found that the DASH plan: lowered the participants” 10-year risk of having a heart attack or other coronary heart disease event by about 18 percent compared to those eating a typical American diet.
In the study, 436 patients (average age 45, 60 percent African-American) had either Stage I high blood pressure (140-159/90-99 mmHg) or were pre-hypertensive (120 – 139/80-89 mmHg) and assigned to one of three diets: the DASH eating plan; a typical American diet (low in minerals, such as potassium, magnesium and calcium, and high in saturated fat, total fat, and cholesterol); or the typical American diet plus additional fruits and vegetables.
To determine how DASH affected coronary heart disease risk, researchers plugged their data (blood pressure and cholesterol results) into the Framingham Heart Risk Equation and calculated the 10-year risk of developing coronary heart disease, researchers said.
This research confirms that people can benefit from eating according to the DASH plan.
The research has been reported in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
September 20th, 2010 at 11:33 pm
A team of scientists has begun exploring what can be learned from the diet of cavemen who lived more than two million years ago.
Research will focus on how the food eaten by hunter-gatherers could enhance modern day nutrition.
Our ancestors in the palaeolithic period, which covers 2.5 million years ago to 12,000 years ago, are thought to have had a diet based on vegetables, fruit, nuts, roots and meat.
Cereals, potatoes, bread and milk did not feature at all. It was only with the dawn of agriculture (around 10,000 years ago) that our diets evolved to include what we think of as staple foods now.
So are we programmed to eat what we do today – or are we better suited to the diet of our ancestors?
Global brand giant Unilever has brought scientists and experts from fields as diverse as evolutionary genetics, anthropology, food science and botany together to find out the answer.
September 27th, 2010 at 12:07 pm
Spending more on food isn’t the only way to buy the healthiest diet, new research shows.
“Increased spending on nuts, soy and beans, and whole grains, and less spending on red and processed meats and high-fat dairy, may be the best investment for dietary health,” Dr. Adam M. Bernstein and colleagues from the Harvard School of Public Health in Boston and colleagues conclude.
The trick, according to the researchers, is to spend more on plant-based foods.
Several studies suggest that living on junk food can be cheaper than eating lots of fresh fruits and vegetables, the researchers note in the American Journal of Clinical Nutrition. Research from the UK, France, Spain, and the Netherlands has also found that eating a healthy diet costs more. However, there is some evidence that “healthy diets can be obtained at different levels of spending,” the authors write.
To compare the relationship between food spending and diet healthfulness, the team assessed diet and spending data for 78,191 women participating in the Nurses’ Health Study. They rated the women’s eating habits and multivitamin intake according to the Alternative Healthy Eating Index (AHEI), a tool they developed, with points awarded for consuming healthier items.
Those with the healthiest diets, whose average AHEI score was 59, spent about $4.60 per day on food, compared to about $3.70 per day for the women with the least healthy diets, who had an average AHEI score of 30.
But when the researchers divided the women into five groups based on how much money they spent on food, they found a wide range in AHEI scores within each spending group. The AHEI score difference between the bottom 10 percent and the top 10 percent within each spending group ranged from 25 to 29, the researchers point out.
In previous research, they add, a 20-point AHEI score increase has been linked to a 25 percent lower risk of heart disease.
Spending more on nuts, soy and beans, and whole grains was associated with a higher AHEI score, the researchers found, while spending more on red meat, processed meat and high fat dairy were associated with a lower score. “Fish and poultry, vegetables, and fruit and fruit juice offer the next best investment,” Bernstein and his colleagues say.
They conclude: “Although spending more money is associated with a healthier diet, large improvements in diet may be achieved without increased spending.”
October 3rd, 2010 at 11:38 pm
Renowned cardiovascular and thoracic surgeon, Dr Ramakanta Panda, today attributed the rise of heart diseases in India to the change in lifestyle, lack of exercise, coupled with bad food habits, smoking and stress.
While releasing a book by Dr Ramesh Kapadiya here, he said obesity and diabetes have worsened the problem. He said bad food habits have led to the cardiac problems.
Dr Panda, who is vice-chairman, Asian Heart Institute, is the man who set right Prime Minister Manmohan Singh’s faltering heart in January 2009. He was awarded the Padma Bhushan in March 2010.
Subsequently, in April 2010, he was also nominated by the Union Health Ministry to the Institute Body (IB), the highest governing body of the All India Institute of Medical Sciences (AIIMS). He is credited for being among the first surgeons in the country to introduce the concept of ‘total arterial revascularisation’, as well as being one of the pioneers of ‘off-pump’ (beating heart) bypass surgery and redo bypass surgery.
Under his leadership, his surgical team has successfully performed over 11,000 bypass surgeries, more than 1,000 repeat (redo) bypass surgeries, as well as more than 2,000 high-risk surgeries.
On the occasion, Dr Kapadia said fear of heart disease is a major factor in heart problems. Simple exercises and change in lifestyle not only helps those who have suffered a stroke but also help prevent the disease.
Dr Kapadia has been running the Universal Health programme for the last 20 years.
October 10th, 2010 at 10:50 pm
The parts of our DNA which may influence body shape, including the classic “apple” or “pear” shape in women, have been revealed.
A UK study in Nature Genetics found the locations of 13 genes which may play a role, with a stronger effect in women.
Where body fat lies may affect diabetes and heart disease risk, so the results could shed light on those diseases.
A British Heart Foundation spokesman said the findings could lead to new dietary advice or medicines.
It is known that men and women who carry more fat around their waists compared with their bottoms and thighs are more prone to diabetes and heart disease – but the reason why fat accumulates in different places is far less clear.
The scientists, led by researchers at Oxford University and the Medical Research Council, looked at the genetic code of more than 77,000 people, looking for genetic regions which could be linked to differences in body fat distribution.
Although the 13 locations highlighted probably only account for a tiny fraction of the variation in the ratio between waist and hip, they are more likely to point towards the underlying body mechanisms which control fat storage.
Genes known to be involved in controlling cholesterol, insulin, and insulin resistance – linked to the development of diabetes – fall within the 13 regions.
October 10th, 2010 at 10:49 pm
People who eat plenty of whole grains have higher quality diets overall, new research shows; the problem is that, in the U.S. at least, these people are few and far between.
Less than 5 percent of the 19- to 50-year-old Americans surveyed in 1999-2004 said they ate at least three servings of whole grain daily, according to the report in the October issue of the Journal of the American Dietetic Association.
During this period, there were no specific guidelines on how much whole grain people should be eating, study author Dr. Carol E. O’Neil of Louisiana State University in Baton Rouge noted; people were simply told to consume “several servings.” But in 2005, new Dietary Guidelines for Americans specified three servings of whole grains daily as the optimal amount.
There is ample evidence that consuming whole grains-meaning the outer portion of the kernel has not been removed-is associated with a lower risk of heart disease, stroke, type 2 diabetes, obesity, and even certain types of cancer, although the mechanism behind their beneficial effects is not clear, O’Neil and her team note in their report.
O’Neil and her colleagues looked at the survey data to assess the relationship between whole grain intake and diet quality. Their analysis included 7,039 men and women between 19 and 50 years old and another 6,237 people 51 and older.
The younger group ate less than two-thirds of a serving of whole grains daily, on average, while the older people ate just over three-quarters of a serving, the researchers found. But the fraction of people who ate the most whole grain also consumed more fiber, healthy fats, and vitamins and minerals, while eating less sugar, unhealthy fat, and cholesterol.
Because the study looked at only one point in time, it cannot assess the health effects of the subjects’ eating habits. “We can only say that consumption of whole grain is associated with improved nutrient intake or diet quality,” O’Neil said. “We know from previous studies that consumption of whole grains is associated with a generally healthier lifestyle.”
Even though Americans now have specific advice on how much whole grain they should be eating, it’s unlikely that the percentage of people eating enough whole grain has changed much since the survey was done, according to O’Neil. “People just don’t eat whole grains, although an increasing number of whole grain foods are available.”
Also, many people don’t know what exactly whole grains are, what types of foods contain them, and why they’re good for you, O’Neil said. For more information, she recommends checking out the MyPyramid Web site (www.mypyramid.gov/) and the Whole Grains Council (here).
“I also think that people are a little afraid of whole grains-that they won’t like them or that their children won’t like them,” she added. “To these people, I would recommend that they find out more about them and try them-after all, popcorn is a whole grain, many cereals are whole grains, and a wide variety of whole grain breads and pastas are available.”
November 20th, 2010 at 9:37 pm
A diet combining fruit and vegetables with foods such as fish, poultry and nuts “can protect you against heart attack”, reported The Independent.
The news is based on a well-conducted trial which tested the DASH diet, a diet high in fruit and vegetables but low in saturated fat that is recommended by the US government. The study enrolled 459 healthy people with slightly high blood pressure and randomly assigned them to follow the DASH diet, a high-fat “American” diet or an American diet supplemented with more fruit and vegetables. After eight weeks, the DASH diet lowered blood pressure and cholesterol, and decreased the participants’ risk of developing heart disease in the next 10 years more than the other diets.
This study has numerous strengths, but it only estimated future heart disease risk rather than monitoring participants over 10 years. Additionally, the risk of heart disease at the start of this study was very low at only 1%, and the DASH diet reduced this risk by only a minimal amount. Despite these small limitations, this study demonstrates the importance of blood pressure as a risk factor for coronary heart disease and the role a balanced diet might play in reducing this risk.
Where did the story come from?
This study was carried out by researchers from Johns Hopkins University, Baltimore. This particular trial was funded by the US National Center for Research Resources, and individual researchers received various other grants and research awards. The trial used data from a previous study, the DASH trial, which was sponsored by the US National Heart, Lung and Blood Institute. The study was published in the peer-reviewed medical journal Circulation.
In general, The Independent accurately reflected the findings of this well-conducted study, but did not mention some important limitations.
What kind of research was this?
This randomised controlled trial investigated the effects of dietary pattern on the 10-year risk of coronary heart disease (CHD). A randomised controlled trail is the best way of investigating a treatment’s ‘efficacy’, i.e. its effectiveness under ideal test conditions.
Dietary studies frequently have an inherent limitation in that it is difficult to accurately control how well a person adheres to the experimental diet being tested. However, this trial had the benefit of providing all the participants’ meals.
What did the research involve?
The researchers analysed findings of the Dietary Approaches to Stop Hypertension (DASH) trial, a previous study that assessed how various short-term dietary interventions affected high blood pressure. The trial had enrolled 459 healthy people with an average age of 45 and blood pressure that was on the high side of normal (average 131/85 mmHg) but not yet considered to be high. The researchers excluded participants with any significant illness, high cholesterol, any cardiovascular event in the previous six months or a BMI higher than 35kg/m2 (a BMI over 25kg/m2 is above ideal weight).
Participants were randomly assigned to follow one of three dietary patterns for eight weeks:
* a control diet: a “typical American diet”, high in saturated fat and cholesterol, low in minerals such as calcium and magnesium
* the F/V diet: rich in fruit and vegetables but otherwise similar to the control diet
* the DASH diet: rich in fruit, vegetables and low-fat dairy, and with a higher ratio of polyunsaturated fat to saturated fat than the other diets
Diets were reportedly prepared in research kitchens, with lunch and dinner prepared on site and breakfast provided for participants in a cooler to be eaten at home. Participants were also asked to record any additional items they consumed, including drinks and added salt. Blood pressure was measured on five occasions during the last two weeks of the study and the average measure was calculated. Cholesterol was also checked.
This subsequent study took the data from the DASH trial and applied the Framingham heart risk tool, a recognised method for predicting an individual’s risk of developing coronary heart disease (CHD). The researchers estimated the 10-year CHD risk of each participant at the beginning of the study and after eight weeks of their assigned diet. This heart risk calculation method takes into account several factors that can contribute to CHD risk, including gender, age, blood pressure, smoking status and diabetes.
What were the basic results?
At the start of the study, all participants had a low risk of developing CHD within the next 10 years (0.98% on average). The researchers found that, compared with the control diet, following the DASH diet for eight weeks:
* lowered blood pressure
* lowered total cholesterol
* lowered LDL (“bad” cholesterol)
* lowered HDL (“good” cholesterol)
At the end of the eight-week study period, there was no significant difference in 10-year CHD risk between the control and F/V diet groups. However, the DASH group had a significantly greater decrease in their 10-year CHD risk compared to the control group and the F/V group.
Over the course of the trial, participants in the DASH group had:
* an 18% decrease in their CHD risk compared to those in the control group (relative risk [RR] 0.82, 95% confidence interval [CI] 0.75 to 0.90)
* an 11% decreased risk compared to those in the F/V group (RR 0.89, 95% CI 0.81 to 0.97)
How did the researchers interpret the results?
The researchers concluded that the DASH diet, which was low in saturated fat and high in fruit and vegetables, decreased the 10-year CHD risk more than a diet high in fruit and vegetables alone or a typically American control diet that was high in saturated fat.
Conclusion
This well-conducted trial benefits from its relatively large size, accurate provision of the three randomised diets and high study completion rates (95%). It also featured a reliable study outcome by using the average of a series of blood pressure measures, which is preferable to relying on a single blood pressure reading.
The study found that eight weeks of the DASH diet, which was rich in fruit and vegetables and low in saturated fat, lowered blood pressure and cholesterol. This contributed to a decrease in predicted 10-year CHD risk. The DASH diet reduced this risk by 18% compared to a high-saturated fat “American” diet and by 11% compared to a diet similar to the American diet but with higher intake of fruit and vegetables.
Some points to note when interpreting this study include:
* All participants in this study had a low risk of developing coronary heart disease in the next 10 years (only about 1%). The DASH diet lowered this 1% risk by approximately one-tenth compared with the diet high in fruit and vegetables and by approximately one-fifth compared to the high-fat diet. Therefore, although the DASH diet lowered risk further, the overall risk remained low in all groups and the differences in risk between the groups were small.
* Although the tool used to calculate 10-year CHD is fairly reliable and commonly used, it is still only an estimate. The people were not followed up over 10 years to see whether they developed heart disease.
* This was only a brief eight-week intervention period. The effects of continuing these diets in the long term are unclear.
* The content of these diets is unclear. Although the newspapers reported that a more balanced diet involving nuts, chicken and fish was the most beneficial, the researchers did not describe the particular foods the participants ate, the calorific content or how much fat and cholesterol the diets contained.
* There were some differences between the three dietary groups at the start of the study. Those in the DASH group had a lower starting cholesterol level than participants in the F/V and control groups. This is an important difference as it could affect blood pressure.
* 60% of the participants in the trial were of African-American ethnicity, 35% were white and the remainder were of other ethnicity. Subgroup analysis also demonstrated that there was a greater decrease in CHD-risk in African-American participants. Therefore, it seems that these results are most applicable to this population group, which should be taken into account when generalising results to all ethnic populations.
* As the researchers acknowledge, this study was too small to reliably predict how the diets tested may affect other population subgroups, such as postmenopausal women, people with higher CHD risk or people with existing CHD.
Overall, this well-conducted study demonstrates the importance of blood pressure as a risk factor for coronary heart disease. It also supports the benefits of fruit and vegetables and low saturated fat as part of a healthy lifestyle to further modify the risk of heart disease.