One of the largest studies on what is good (and bad) for heart disease prevention has just been published in the Journal of the American College of Cardiology. This study (Satija 2017) conducted by the Harvard T.H. Chan School of Public Health (Boston, USA) is an analysis of three studies (Nurses’ Health Study, Nurses Health Study 2, and Health Professionals Follow-up Study).
Results:
Healthy plant foods lower heart
disease risk.
Unhealthy plant foods increase heart
disease risk.
Animal products (viewed as on big
group) increase heart disease risk – see note below (Satija
2017).
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Dietary pattern
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Effect of CHD (coronary heart disease) risk
|
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more healthy plant
foods
less unhealthy plant
foods
less animal products
|
25% decrease in CHD
|
|
more unhealthy plant
foods
less healthy plant
foods
less animal products
|
32% increase in CHD
|
|
(Satija
2017)
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|
|
Healthy
plant foods
- Whole grains: Whole grain breakfast
cereal, other cooked breakfast cereal, cooked oatmeal, dark bread, brown
rice, other grains, bran, wheat germ, popcorn
- Fruits: Raisins or grapes, prunes, bananas,
cantaloupe, watermelon, fresh apples or pears, oranges, grapefruit, strawberries,
blueberries, peaches or apricots or plums
- Vegetables: Tomatoes, tomato juice, tomato sauce,
broccoli, cabbage, cauliflower, brussels sprouts, carrots, mixed vegetables,
yellow or winter squash, eggplant or zucchini, yams or sweet potatoes, spinach
cooked, spinach
raw, kale or mustard
or chard greens, iceberg or head lettuce, romaine or leaf lettuce, celery,
mushrooms, beets, alfalfa sprouts, garlic, corn
- Nuts: Nuts, peanut butter
- Legumes: String beans, tofu or soybeans, beans or
lentils, peas or lima beans
- Vegetable oils: Oil-based salad dressing, vegetable oil used
for cooking
- Tea and coffee: Tea, coffee, decaffeinated coffee
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|
Less
healthy plant foods
- Fruit juices: Apple cider (nonalcoholic) or juice, orange
juice, grapefruit juice, other fruit juice
- Refined grains: Refined grain breakfast cereal, white bread,
English muffins or bagels or rolls, muffins or biscuits, white rice, pancakes
or waffles, crackers, pasta
- Potatoes: French fries, baked or mashed potatoes,
potato or corn chips
- Sugar sweetened beverages: Colas with caffeine and sugar,
colas without caffeine but with sugar, other carbonated beverages with sugar,
noncarbonated fruit drinks with sugar
- Sweets and desserts: Chocolates, candy bars, candy
without chocolate, cookies (home-baked and ready-made), brownies, doughnuts,
cake (home-baked and ready-made), sweet roll (home-baked and ready-made), pie
(home-baked and readymade), jams or jellies or preserves or syrup or honey
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Animal
products (as one group)
- Animal fat: Butter added to food, butter or lard used
for cooking
- Dairy*: Skim low fat milk, whole milk, cream, sour
cream, sherbet, ice cream, yogurt, cottage or ricotta cheese, cream cheese,
other cheese
- Egg*: Eggs
- Fish* or seafood: Canned tuna, dark meat fish,
other fish, shrimp or lobster or scallops
- Meat: Chicken or turkey with skin, chicken or
turkey without skin, bacon, hot dogs, processed meats, liver, hamburger, beef
or pork or lamb mixed dish, beef
or pork or lamb main
dish
- Miscellaneous animal-based foods: Pizza, chowder or cream soup, mayonnaise
or other creamy salad dressing
*Note that “healthy
animal foods [such as] dairy except ice cream, egg, and fish” did not seem to
have this negative effect on heart disease risk.
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“[W]e found that even a slightly
lower intake of animal foods combined with higher intake of healthy plant foods
is associated with lower CHD risk.” (Satija 2017)
“Medical and health professionals
should guide patients to increase intake of healthy plant foods, such as whole
grains, fruits, vegetables, and nuts, and reduce intake of animal foods and
less healthy plant foods such as SSB [sugar sweeted beverages] for CHD
prevention.” (Satija 2017)
A comment on this study:
“This study adds to the evidence of
gradations of adherence to an overall PDI [more plants, less animal products] with
CHD incidence, such that one could propose a risk-based approach to PDI prescription:
secondary prevention after cardiovascular events and patients at high risk
having a stronger recommendation for a strictly hPDI [more healthy plant foods,
less unhealthy plant foods, less animal products]. They [these studies here] cannot address the
benefits of a purely plant-based diet (vegan) because this was a very small
population in their study.
Substantial evidence indicates that
a predominantly plant-based diet is associated with improved
cardiovascular risk factors, reduced
incidence, and progression of CHD. Not all plant-based foods are
equally healthy; rather, plant-based
diets including whole grains as the main form of carbohydrate, unsaturated fats
as the predominate form of dietary fat, an abundance of fruit and vegetables,
and adequate n-3 fatty acids can play an important role in preventing CVD. Such
diets, which have many other health benefits including the prevention of
several chronic diseases, deserve more emphasis in dietary recommendations.
[…]
If, for example, widespread adoption
of plant-based nutrition reduced the incidence of hypertension to 25% of the
current rate, this could result in savings of nearly 30% of the Medicare budget.
[…]
What, then, does hPDI [more healthy
plant foods, less unhealthy plant foods, less animal products] really mean? It
means both a challenge and an opportunity for cardiology. Until recently, as a
group, cardiologists have not delved deeply into nutrition, treating CVD’s
downstream effects rather than obliterating its roots, leaving primary and
secondary prevention opportunities on the table.
It is time that we educate ourselves
on dietary patterns, risk, and outcomes, and focus more on “turning off the
faucet” instead of “mopping up the floor”.”
Dr. Kim Allan Williams Sr., Division of Cardiology, Rush University
(Chicago, USA) (Williams 2017)
References:
Satija A et al.: Healthful and
Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S.
Adults. J Am Coll Cardiol. 2017 Jul 25;70(4):411-422. doi:
10.1016/j.jacc.2017.05.047
Williams KA Sr, Patel H: Healthy Plant-Based
Diet: What Does it Really Mean? J Am Coll Cardiol. 2017 Jul
25;70(4):423-425. doi: 10.1016/j.jacc.2017.06.006