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A recent study was good news for those wishing to lower their chances of developing heart disease (cardiovascular disease) without the use of medications. Instead, focus on the foods you eat, specifically those in a Mediterranean-style diet.

The Univ. of Sydney researchers did an analysis of 16 existing studies (with 722,495 women) and found that women following a Mediterranean diet lowered their odds of developing heart disease by 24% and lowered their risk of early death by 23%.

In this study, a Mediterranean diet meant eating a diet rich in fruits, vegetables, whole grains, legumes, nuts, seeds, extra virgin olive oil. Moderate amounts of seafood, low to moderate in wine consumption, and low in red/processed meats, dairy products, animal fat, and processed foods.

Why is the Mediterranean diet beneficial? The diet focuses on whole foods that are also rich in fiber, antioxidants, has an increased intake of all sorts of nutrients (vitamins, minerals, flavanols, etc.), less oxidative stress, it's anti-inflammatory, reduced glycemic load, boosts the immune system, and feeds the beneficial microbes in our gut microbiome.

Interestingly, studies find that frequent consumption of extra virgin olive oil (EVOO) lowers the risk of death from several diseases (heart disease, cancer, neurogenerative disease, and respiratory disease), lowers the incidence of breast cancer, and promotes healthier brain aging. A Mediterranean diet is associated with numerous health benefits (e.g., lower dementia risk) besides a lower heart disease risk.

These findings are important because heart disease is the leading cause of death globally, according to the World Health Organization. According to the CDC, it is the number 1 killer of women in the United States.

From Medical Xpress: Mediterranean diet cuts women's cardiovascular disease and death risk by nearly 25%, finds study

Sticking closely to a Mediterranean diet cuts a woman's risks of cardiovascular disease and death by nearly 25%, finds a pooled data analysis of the available evidence—the first of its kind—published online in the journal Heart. ...continue reading "Study Finds Mediterranean Diet Lowers the Risk of Developing Heart Disease In Women"

Another recent study found that consuming artificial sweeteners do harm. In August a study found that artificial sweeteners alter both the oral and gut microbiomes in a negative way. Other earlier studies found an association with high blood pressure, inflammation, weight gain, vascular dysfunction, and increased risk of cancer.

Now, a large study found that high consumption of artificial sweeteners is associated with increased risk of heart disease (cardiovascular disease), including heart attacks and strokes (cerebrovascular events).

What is high consumption of artificial sweetener? One individual packet of artificial sweetener or a 100 mL of diet soda is about 42.46 mg/day, while in this study high sweetener consumption is about 77.62 mg/day. So high consumption is not even 2 diet sodas or packets per day.

Bottom line: Artificial sweeteners are NOT a healthy or good alternative to sugar (or maple syrup or honey). Also, avoid high fructose corn syrup - that has its own problems. Artificial sweeteners are found in highly processed foods - try to also avoid those for your health.

Cardiovascular diseases are the leading cause of death worldwide. Avoiding sugar and instead consuming artificial sweeteners is not going to help you achieve health. But improving your overall diet will, such as eating a diet rich in whole grains, fruits, vegetables, seeds, nuts, legumes (beans).

From Medical Xpress: Study suggests possible link between artificial sweeteners and heart disease

A large study of French adults published by The BMJ today suggests a potential direct association between higher artificial sweetener consumption and increased cardiovascular disease risk, including heart attack and stroke. ...continue reading "Health Harms Associated With Artificial Sweeteners"

Y chromosome (in red). Credit: Wikipedia

Did you know that a significant percentage of men lose the male sex chromosome in some of their cells as they age? About 40% of 70 year olds! This loss may explain why so many men die several years before women.

The loss of the male Y chromosome in some cells (mosaic loss) has health effects. It is associated with an increased risk of early death and some age-related diseases in men, such as heart disease and heart failure. This loss mainly happens in cells with a rapid turnover, such as blood cells, and does not happen in male reproductive cells.

A recent two part study in both mice and human males found that this Y chromosome loss resulted in heart muscle scarring (fibrosis), which led to increased risk of heart problems and heart failure. The researchers discuss a drug (pirfenidone) that may help with treatment.

Why is this happening? The researchers point out that as we age, more and more gene mutations are occurring, that is, the DNA of our cells accumulate mutations as we age. Some of them are due to our own choices, such as smoking, exposures to toxic chemicals, radiation, our lifestyle. Others are out of our control (e.g., aging).

From Science Daily: Loss of male sex chromosome leads to earlier death for men

The loss of the male sex chromosome as many men age causes the heart muscle to scar and can lead to deadly heart failure, new research from the University of Virginia School of Medicine shows. The finding may help explain why men die, on average, several years younger than women. ...continue reading "Many Men Lose the Male Sex Chromosome As They Age"

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Well... once again a study found that frequently eating fried food is not good for health - that it is linked to a higher risk of major heart disease and major cardiovascular events (e.g. heart attack, stroke).

Apparently there has been some debate over this issue, so researchers at  Shenzhen University in China reviewed 19 studies on fried food consumption. They found that there is a linear increase - the more fried food is eaten each week, the higher the risks of heart disease, major cardiovascular events, and heart failure.

The risk for a major cardiovascular event or heart disease increases by 2 to 3% with each additional serving (one serving = 114 g or 4 oz) of fried food per week. Which bring us to the bottom line: Eat fried food sparingly!

From Science Daily: Fried food intake linked to heightened serious heart disease and stroke risk

Fried-food intake is linked to a heightened risk of major heart disease and stroke, finds a pooled analysis of the available research data, published online in the journal Heart. And the risk rises with each additional 114 g (4 oz) weekly serving, the analysis indicates.  ...continue reading "Fried Foods and Risk of Heart Disease"

More evidence that there are health benefits from physical activity, even minimal amounts. Ohio State University researchers found that physical activity, even 10 minute at a time physical activity or exercise, adds up and is associated with lower amounts of cardiovascular (heart) disease in the next ten years - even for obese and overweight persons.

Being overweight or obese are risk factors for cardiovascular disease, type 2 diabetes, hypertension, and cancer. About 40% of Americans are obese and 32% are overweight, so having a way to simply and cheaply lower rates of cardiovascular disease is wonderful. Overweight is body mass index (BMI) of 25.0 to 29.9, obesity is BMI 30 or higher, and normal BMI is 18.5 to 24.8 (see CDC guidelines)

The researchers found that physical activity is more important than weight of a person in determining the risk of cardiovascular disease over the next 10 years. Unfortunately 43% of the overweight participants and 53% of the obese participants reported being sedentary (did not engage in at least 10 minutes of continuous physical activity each week) - and these groups had the highest risk of cardiovascular disease.

What counts as exercise or physical activity? Physical activity should be at least 10 continuous minutes or more, and ideally add up to 150 minutes or more each week. All moderate (e.g. brisk walking, light yard work, vacuuming, dancing) and vigorous (e.g. jogging, swimming laps, aerobics, heavy yard work) recreation activities count. The study found that engaging in less than 150 minutes a week also lowered the risk for cardiovascular disease, just not as much as for those with 150 minutes or more each week.

Government guidelines: The Physical Activity Guidelines from the US Department of Health and Human Services recommends that adults do at least 150 to 300 minutes of moderate-intensity physical activity a week, or 75 to 150 minutes of vigorous-intensity activity, or an equivalent combination of moderate- and vigorous-intensity activity.

Bottom line: Try to move, move, move as much as possible! Yes, a nice 20 minute (1 mile) walk counts!

From Medical Xpress: Not much exercise needed to lower heart disease risk for overweight people

A new study suggests, for obese or overweight adults, that any amount of exercise might lower the risk of developing cardiovascular disease in the next 10 years.  ...continue reading "Any Amount of Physical Activity Is Good For Overweight Adults"

A recent study in the Journal of Internal Medicine had interesting results regarding sun exposure - more was beneficial for health.

In the study, women were followed for 20 years, and any  deaths were put into one of 3 groups: as being from: heart disease, cancer, or other (non-heart disease and non-cancer). Swedish women followed for 20 years found that the more sunlight exposure they had, the longer the life expectancy, the less death from heart disease (cardiovascular disease) and causes other than heart disease or cancer (non-heart disease and non-cancer group), but the more skin cancer (basal cell carcinoma, squamous cell carcinoma and melanoma) they developed. 

Thus the main finding is of a dose-dependent relationship between sun exposure and life expectancy.

One surprising result was that nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group. Those who avoided sun exposure had an increased risk of death mainly due to heart disease and "other causes" (non-cancer/non-heart disease).

I wondered about other cancers in this study, and this is all they had to say in the journal article:  "Thus, women with NMSC (nonmalignant skin cancer) had a 37% higher prevalence of other internal cancers than those without NMSC and a fourfold increased prevalence of MM (malignant melanoma). The incidence of other internal cancer was not increased subsequently on NMSC diagnosis."  I now have another question:  How do the women with cancer in the high and low sun exposure group do after another 10 or 20 years?  I would have liked for this study to continue longer.

The researchers felt that sunshine and vitamin D had a role in these results, and suggested that we need to rethink the "avoid sunshine" advice now given to people. In other words, some sunshine is good for health. From Science Daily:

Why do sunbathers live longer than those who avoid the sun?

New research looks into the paradox that women who sunbathe are likely to live longer than those who avoid the sun, even though sunbathers are at an increased risk of developing skin cancer. An analysis of information on 29,518 Swedish women who were followed for 20 years revealed that longer life expectancy among women with active sun exposure habits was related to a decrease in heart disease and noncancer/non-heart disease deaths, causing the relative contribution of death due to cancer to increase.

Whether the positive effect of sun exposure demonstrated in this observational study is mediated by vitamin D, another mechanism related to UV radiation, or by unmeasured bias cannot be determined. Therefore, additional research is warranted. 

"We found smokers in the highest sun exposure group were at a similar risk as non-smokers avoiding sun exposure, indicating avoidance of sun exposure to be a risk factor of the same magnitude as smoking," said Dr. Pelle Lindqvist, lead author of the Journal of Internal Medicine study. "Guidelines being too restrictive regarding sun exposure may do more harm than good for health."

Get your omega-3 fatty acids from either fish or flaxseed (or other seeds).From Science Daily:

Nothing fishy about health benefits of plant-based omega-3 fatty acid

Increasing the amount of omega-3s in your diet, whether from fish or flax, will likely decrease your risk of getting heart disease, according to Penn State nutritionists. A substantial amount of evidence exists supporting the heart-health benefits of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), marine-derived omega-3 fatty acids. However, much less evidence exists to demonstrate the positive effects of alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid.

EPA and DHA can be found in seafood and fish oil, and are often consumed in the form of dietary supplements. ALA is found in flaxseed and its oil, vegetable oils, and some nuts, and is now available in supplement form. EPA and DHA have been available for much longer. Other sources of ALA, EPA and DHA are fortified foods such as orange juice, eggs, peanut butter, margarine and bread, among others. While there are many other omega-3 fortified foods in the market place, most are relatively low in omega-3 fatty acids.

Omega-3 fatty acids are considered essential for human health, but the body does not produce them -- therefore they must be consumed in order to maintain appropriate levels.

In reviewing existing literature on the subject, the researchers have come to the conclusion that ALA is likely just as effective in preventing cardiovascular disease as EPA and DHA have proven to be, as they report on the current issue of Advances in Nutrition.

To celebrate National Nut Day, two articles about health benefits of nuts. From Medical Daily:

National Nut Day 2014: Peanuts, Tree Nuts, And How Each Helps Your Health

For people who already eat plenty of meat and dairy products…nuts and ‘nutty’ legumes, like Brazil nuts, cashews, peanuts and walnuts, are a good nutritional alternative to meat,” Dr. Donal Murphy-Bokern, independent agri-environmental scientist and author of several studies on food system impacts, said in a statement. Heeding this advice means people can reap the benefits that come with eating nuts — Protein! Fiber! Omega-3 fatty acids! 

Nuts fall into two categories: peanuts (which are really legumes) and tree nuts. The latter includes Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, walnuts and America’s beloved almonds. ...” And existing research generalizes that eating nuts does everything from reduce risk for a slew of diseases, maintains weight, boosts gastrointestinal and bone health, even adds years to a person’s life.

As previously mentioned, nuts are pretty much equal in terms of calories. There are, however, some nuts that have more heart-healthy nutrients and fats than others. See: pistachios. This particular tree nut is high in healthy fats called monounsaturated fats (MUFA). MUFAs are often associated with belly fat.

One study published in the journal Nutrition found that when middle-aged adults at risk for heart disease and diabetes incorporated more pistachios into their diet, they weighed less and lessened their cholesterol and blood sugar levels after just six months. And a separate study from UCLA found people who regularly ate pistachios lost an average of 10 to 12 pounds. Almonds and cashews are additional nuts high in MUFAs. 

The Harvard School of Public Health reported, “several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study have shown a consistent 30 percent to 50 percent lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease associated with eating nuts several times a week.”

Though almonds tend to be associated most with heart health, it’s actually walnuts that take the number one spot. ...Health reported a 2006 Spanish study, which “suggested that walnuts were as effective as olive oil at reducing inflammation and oxidation in the arteries after eating a fatty meal.”

Folate, as defined by Harvard Medical School, is “the naturally occurring form of the vitamin that is in foods or in the blood.” It’s also the vitamin that staves off brain atrophy, or the progressive loss of brain cells over time... A study published in the American Journal of Psychiatry found folate may ward off depression, too. And which nut is super rich in folate? Unsalted peanuts...peanuts are also high in vitamin E and niacin, both of which boost brain health. Hazelnuts and almonds are known to have concentrated amounts of E, too, so either nut is bound to help your noggin.

Study done in mice, but shows benefits of walnuts to brain. From Science Daily:

Fight against Alzheimer's disease: New research on walnuts

A new animal study published in the Journal of Alzheimer's Disease indicates that a diet including walnuts may have a beneficial effect in reducing the risk, delaying the onset, slowing the progression of, or preventing Alzheimer's disease. Research led by Abha Chauhan, PhD, head of the Developmental Neuroscience Laboratory at the New York State Institute for Basic Research in Developmental Disabilities (IBR), found significant improvement in learning skills, memory, reducing anxiety, and motor development in mice fed a walnut-enriched diet.

The researchers suggest that the high antioxidant content of walnuts (3.7 mmol/ounce) may have been a contributing factor in protecting the mouse brain from the degeneration typically seen in Alzheimer's disease. Oxidative stress and inflammation are prominent features in this disease, which affects more than five million Americans.

Walnuts have other nutritional benefits as they contain numerous vitamins and minerals and are the only nut that contains a significant source of alpha-linolenic acid (ALA) (2.5 grams per ounce), an omega-3 fatty acid with heart and brain-health benefits. The researchers also suggest that ALA may have played a role in improving the behavioral symptoms seen in the study.

What if a doctor said you could avoid years of taking medication (and all their side effects and cost), better heart health, and avoid a heart attack by adopting some lifestyle changes. Could you do it? Would you? How to avoid 4 out 5 heart attacks, from Medical Xpress:

Healthy lifestyle choices may dramatically reduce risk of heart attack in men

Following a healthy lifestyle, including maintaining a healthy weight and diet, exercise, not smoking and moderating alcohol intake, could prevent four out of five coronary events in men, according to a new study publishing today in the Journal of the American College of Cardiology.

While mortality from heart disease has declined in recent decades, with much of the reduction attributed to medical therapies, the authors said prevention through a healthy lifestyle avoids potential side effects of medication and is more cost effective for population-wide reductions in coronary heart disease. 

For the study, researchers examined a population of 20,721 healthy Swedish men aged 45-79 years of age and followed them for 11 years. Lifestyle choices were assessed through a questionnaire exploring diet, alcohol consumption, smoking status, level of physical activity and abdominal adiposity (belly fat). Men in the study with the lowest risk were non-smokers, walked or cycled for at least 40 minutes per day, exercised at least one hour per week, had a waist circumference below 95 centimeters, consumed moderate amounts of alcohol, and followed a healthy diet with a regular consumption of fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish.

The researchers found a clear reduction in risk for heart attack for each individual lifestyle factor the participants practiced. For instance having a low-risk diet together with a moderate alcohol consumption led to an estimated 35 percent lower risk of heart attack compared to the high-risk group, those who practice none of the low-risk factors.

Men who combined the low-risk diet and moderate alcohol consumption with not smoking, being physically active and having a low amount of abdominal fat, had 86 percent lower risk. Researchers found similar results in men with hypertension and high cholesterol levels.

The burden of cardiovascular disease could be significantly reduced through programs targeted to men and promoting low-risk lifestyle choices. Even in those who take medication, an additional reduction in risk for chronic heart disease has been observed in those with a healthy lifestyle.

From John M., a cardiac electrophysiologist, who expressed his frustration with unnecessary heart disease, and commented on this study on drjohnm.org:

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease.

Let’s be clear and honest: Lifestyle-related disease is largely unnecessary.

These days, there is so much unnecessary disease that caregivers, especially cardiologists, rarely see it. We look past the obesity right to the cholesterol number and ECG. And then we pull out the prescription pad for the guideline-directed pills. Just typing that causes me angst.

More research on the benefits of exercise. From Medical Xpress:

An hour of moderate exercise a day may decrease heart failure risk

In a new study reported in the American Heart Association journal Circulation: Heart Failure, researchers say more than an hour of moderate or half an hour of vigorous exercise per day may lower your risk of heart failure by 46 percent. Heart failure is a common, disabling disease that accounts for about 2 percent of total healthcare costs in industrialized countries. Risk of death within five years of diagnosis is 30 percent to 50 percent, researchers said.

Swedish researchers studied 39,805 people 20-90 years old who didn't have heart failure when the study began in 1997. Researchers assessed their total- and leisure time activity at the beginning of the study and followed them to see how this was related to their subsequent risk of developing heart failure. They found that the more active a person, the lower their risk for heart failure. 

From Medical Xpress:

Workers who exercise lower health risks, cost less

Get moving: just 20 minutes of exercise a day dramatically lowers the risk of diabetes and heart disease, even for employees with a high risk of developing those conditions.

A University of Michigan study looked at the impact of exercise on 4,345 employees in a financial services company that had just started a workplace wellness program. Roughly 30 percent of employees were high risk and suffering from metabolic syndrome, a dangerous cluster of risk factors associated with diabetes and heart disease. Overall, about 34 percent of U.S. adults have metabolic syndrome.

The study found that when the high-risk employees accumulated the government-recommended 150 minutes of moderate-intensity exercise a week, their health care costs and productivity equaled that of healthy employees who didn't exercise enough, said Alyssa Schultz, a researcher at the Health Management Research Center in the U-M School of Kinesiology.

"It was a real surprise, the level of protection physical activity gave to people with metabolic syndrome," Schultz said. 

Research done in mice, but may apply to humans. From Science Daily:

How physical exercise protects the brain from stress-induced depression

Physical exercise has many beneficial effects on human health, including the protection from stress-induced depression. However, until now the mechanisms that mediate this protective effect have been unknown. In a new study in mice, researchers show that exercise training induces changes in skeletal muscle that can purge the blood of a substance that accumulates during stress, and is harmful to the brain.

"In neurobiological terms, we actually still don't know what depression is. Our study represents another piece in the puzzle, since we provide an explanation for the protective biochemical changes induced by physical exercise that prevent the brain from being damaged during stress," says Mia Lindskog, researcher at the Department of Neuroscience at Karolinska Institutet.