Regular walking - protects the Masai against cardiovascular disease

[PRESS RELEASE 18 July 2008]

Extract:

There is strong evidence that the high consumption of animal fats increases the risk of developing cardiovascular disease.  Many scientists have therefore been surprised that the nomadic Masai of Kenya and Tanzania are seldom afflicted by the disease, despite having a diet that is rich in animal fats and deficient in carbohydrates.

Trans fat - Wikipedia, the free encyclopedia

Trans fat - Wikipedia, the free encyclopedia

Coronary heart disease 
 
The primary health risk identified for trans fat consumption is an elevated risk of coronary heart disease (CHD).^[43] A comprehensive review of studies of trans fats was published in 2006 in the New England Journal of Medicine reports a strong and reliable connection between trans fat consumption and CHD, concluding that "On a per-calorie basis, trans fats appear to increase the risk of CHD more than any other macronutrient, conferring a substantially increased risk at low levels of consumption (1 to 3% of total energy intake)".^[4] This study estimates that between 30,000 and 100,000 cardiac deaths per year in the United States are attributable to the consumption of trans fats.^[44]

Bacon - 60% PUFA (Wikipedia), and heart disease connection

Bacon - Wikipedia, the free encyclopedia

Nutrients

Four 14-gram (0.5 oz) slices of bacon together contain 7.45 grams (0.26 oz) of fat, of which about half is monounsaturated, a third is saturated and a sixth is polyunsaturated, and 7.72 grams (0.27 oz) of protein.^[35] Four pieces of bacon can also contain up to 800 mg of sodium, which is roughly equivalent to 1.92 grams of salt. The fat and protein content varies depending on the cut and cooking method.

Health concerns

A 2007 study by Columbia University suggests a link between eating cured meats (such as bacon) and chronic obstructive pulmonary disease. The preservative sodium nitrite is the probable cause,^[36][37] and bacon made without added nitrites is available. Bacon is usually high in salt and saturated fat; excessive consumption of both is related to a variety of health problems. See the articles on saturated fat and salt for more details.

Researchers from the Harvard School of Public Health found in 2010 that eating processed meats such as bacon, preserved by smoking, curing or salting, or with the addition of chemical preservatives, was associated with an increased risk of both heart disease and diabetes.

The same association was not found for unprocessed meat.^[38]

Study (2007) disputes "wholegrain for heart health"

Wholegrain cereals for coronary heart disease  

by the Cochrane Collaboration

[Plain Language Summary]

Wholegrain foods encompass a range of products and examples are wholegrain wheat, rice, maize and oats. The term wholegrain also includes milled wholegrains such as oatmeal and wholemeal wheat.

The evidence found by this review is limited to wholegrain oats, and to changes in lipids as an outcome. There is a lack of studies on other wholegrain foods or diets. There is some evidence from this review that oatmeal foods can beneficially lower lipid levels such as low density lipoproteins (LDL) cholesterol and total cholesterol in those previously diagnosed with risk factors for coronary heart disease (CHD) even with relatively short interventions. However, the results should be interpreted with caution because the trials found are small, of short duration and many were commercially funded. No studies were found that reported the effect of wholegrain foods or diets on deaths from, or occurrence of CHD.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2011 Issue 6, Copyright © 2011 

The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).


This record should be cited as: Kelly SAM, Summerbell CD, Brynes A, Whittaker V, Frost G. Wholegrain cereals for coronary heart disease. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005051. DOI: 10.1002/14651858.CD005051.pub2


Editorial Group: Heart Group

This version first published online: April 18. 2007

Abstract

 

Background

There is increasing evidence from observational studies that wholegrains can have a beneficial effect on risk factors for coronary heart disease (CHD).

 

Objectives 

 

The primary objective is to review the current evidence from randomised controlled trials (RCTs) that assess the relationship between the consumption of wholegrain foods and the effects on CHD mortality, morbidity and on risk factors for CHD, in participants previously diagnosed with CHD or with existing risk factors for CHD.

 

Search strategy

 

We searched CENTRAL (Issue 4, 2005), MEDLINE (1966 to 2005), EMBASE (1980 to 2005), CINAHL (1982 to 2005), ProQuest Digital Dissertations (2004 to 2005). No language restrictions were applied.

 

Selection criteria

 

We selected randomised controlled trials that assessed the effects of wholegrain foods or diets containing wholegrains, over a minimum of 4 weeks, on CHD and risk factors. Participants included were adults with existing CHD or who had at least one risk factor for CHD, such as abnormal lipids, raised blood pressure or being overweight.

 

Data collection and analysis

 

Two of our research team independently assessed trial quality and extracted data. Authors of the included studies were contacted for additional information where this was appropriate.

 

Main results

 

Ten trials met the inclusion criteria. None of the studies found reported the effect of wholegrain diets on CHD mortality or CHD events or morbidity. All 10 included studies reported the effect of wholegrain foods or diets on risk factors for CHD. Studies ranged in duration from 4 to 8 weeks. In eight of the included studies, the wholegrain component was oats. Seven of the eight studies reported lower total and low density lipoproteins (LDL) cholesterol with oatmeal foods than control foods. When the studies were combined in a meta-analysis lower total cholesterol (-0.20 mmol/L, 95% confidence interval (CI) -0.31 to -0.10, P = 0.0001 ) and LDL cholesterol (0.18 mmol/L, 95% CI -0.28 to -0.09, P < 0.0001) were found with oatmeal foods. However, there is a lack of studies on other wholegrains or wholegrain diets.

 

Authors' conclusions

 

Despite the consistency of effects seen in trials of wholegrain oats, the positive findings should be interpreted cautiously. Many of the trials identified were short term, of poor quality and had insufficient power. Most of the trials were funded by companies with commercial interests in wholegrains. There is a need for well-designed, adequately powered, longer term randomised controlled studies in this area. In particular there is a need for randomised controlled trials on wholegrain foods and diets other than oats.

Arthritis & psoriasis medications - reduced diabetes risk

Common rheumatoid arthritis and psoriasis medications are associated with reduced diabetes risk

Common Rheumatoid Arthritis and Psoriasis Medications Are Associated With Reduced Diabetes Risk

ScienceDaily (June 22, 2011) — Individuals with systemic inflammatory conditions, such as rheumatoid arthritis (RA) and psoriasis, experience a 1.5 to 2-fold increased rate of cardiovascular disease. Previous research suggests that inflammation and insulin resistance, linked with these conditions, likely accelerate the development of cardiovascular risk and diabetes. Researchers at Brigham and Women's Hospital (BWH) sought to determine whether commonly used disease-modifying antirheumatic drugs (DMARDs), which are directed against inflammation, might reduce the risk for developing diabetes in patients with RA or psoriasis.

They found that among patients with RA or psoriasis, the risk for developing diabetes was lower for those patients who started TNF inhibitor or hydroxychloroquine.

Their findings are published in the June 22/29, 2011 issue of the Journal of the American Medical Association.

Fish Oils and Heart Disease : A Closer Look

Precious Yet Perilous
Written by Chris Masterjohn Phd

Fish Oils and Heart Disease : A Closer Look
Dozens of randomized, controlled trials have tested the effect of fish oil supplementation and increases in the intake of fatty fish on total and cardiovascular mortality. Virtually all of them have been conducted in people with established heart disease taking drugs such as statins and aspirin, and most of them have lasted fewer than two years. In 2004, the Cochrane Collaboration published a massive review and meta-analysis of these trials.79 Meta-analyses pool the data of many studies together in an attempt to show the big picture and test whether methodological differences between trials or random chance are more likely to account for differences in results. When the authors pooled the data from forty-eight trials lasting longer than six months, the only effect that could be distinguished from chance was a reduced risk of heart failure. Fish oil provided no reduction in total or cardiovascular mortality.
Trials lasting less than one year were most likely to show positive results, while the only trial lasting more than four years—the Diet and Reinfarction 2 (DART 2) trial—showed a 15 percent increase in total mortality and a 30 percent increase in cardiovascular mortality. DART 2 used dietary advice to increase fatty fish intake in addition to fish oil supplementation, so could not be placebo-controlled or double-blind, and unfortunately funding problems led to interruptions of the recruitment process in the middle of the trial. Nevertheless, with over three thousand participants it was one of the largest fish oil trials ever conducted and, with over four years follow-up, it was the longest fish oil trial ever conducted. Thus, we should not casually dismiss the findings of this trial.
A recent meta-analysis brought to light eleven trials that were placebo-controlled and lasted more than one year.⁸⁰ Pooling the data from these studies together showed that fish oil reduced the relative risk of cardiovascular death by 13 percent and reduced the relative risk of all-cause mortality by 8 percent.
The Italian GISSI-Prevenzione and GISSI-Heart Failure trials were the largest included in this meta-analysis and were responsible for most of the effect. These trials, together with the DART 1 trial, suggested that fish oil may prevent arrhythmia in patients with chronic heart failure and patients who have recently survived a heart attack.⁸¹ Researchers provided participants with roughly one gram of long-chain omega-3 fatty acids per day. The GISSI trials found a long-term benefit over the course of almost four years in heart failure patients but a much shorter-term benefit concentrated in the first year of the study in patients who had recently undergone a heart attack. The DART 1 trial similarly found an early benefit of fatty fish consumption and fish oil supplementation in patients who had recently suffered from a heart attack. Fish oil thus seems likely to prevent very specific types of heart failure rather than to prevent heart disease more generally.
None of these trials provided any evidence that healthy people benefit from taking fish oil or that doses higher than one gram of omega-3 fatty acids per day provide any benefit over smaller doses. The results of the DART 2 trial are particularly concerning because, like the results of the Wadsworth Veterans Administration Hospital Study (see sidebar on page 29), they suggest that high intakes of PUFAs may increase the risk of morbidity and mortality when consumed over the course of many years.

Saturated fat and CV disease - Wikipedia, cited references

Saturated fat and cardiovascular disease controversy - Wikipedia, the free encyclopedia

References cited:

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Further reading

• Ffion Lloyd-Williams, Martin O’Flaherty, Modi Mwatsama, et al (July 2008). "Estimating the cardiovascular mortality burden attributable to the European Common Agricultural Policy on dietary saturated fats". Bulletin of the World Health Organization 86 (7): 497–576. Retrieved 2011-01-25.
• Ravnskov, Uffe. (October 1, 2000). The Cholesterol Myths – Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease. Newtrends. ISBN 978-0967089706.
• Steinberg, Daniel. (September 24, 2007). The Cholesterol Wars – The Skeptics vs. the Preponderance of Evidence. Academic Press. ISBN 978-0123739797.

Study (2009) - saturated fat not case heart disease

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease¹,²,³,⁴,⁵

1. Patty W Siri-Tarino,
2. Qi Sun,
3. Frank B Hu, and
4. Ronald M Krauss

- Author Affiliations

1. From the Children's Hospital Oakland Research Institute Oakland CA (PWS-TRMK)the Departments of Nutrition (QSFBH) Epidemiology (FBH) Harvard School of Public Health Boston MA.

Abstract

Background: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health. 

Objective: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) in prospective epidemiologic studies. 

Design: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD. 

Results: During 5–23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 (95% CI: 0.96, 1.19; P = 0.22) for CHD, 0.81 (95% CI: 0.62, 1.05; P = 0.11) for stroke, and 1.00 (95% CI: 0.89, 1.11; P = 0.95) for CVD. Consideration of age, sex, and study quality did not change the results. 

Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

• Received March 6, 2009.
• Accepted November 25, 2009.

Study (2010) - Replace Saturated fat with PUFA to reduce CV disease

NOTE: this is a study of a whole lot of historical studies, not original clinical research

PLoS Medicine: Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects on Coronary Heart Disease of Increasing Polyunsaturated Fat in Place of Saturated Fat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Published in the March 2010 Issue of PLoS Medicine

Dariush Mozaffarian^1,2,3*, Renata Micha², Sarah Wallace²

1 Division of Cardiovascular Medicine and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America, 2 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America, 3 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America

Why Was This Study Done?

Because of the connection between eating SFA and high blood LDL-C levels, reduced SFA consumption is recommended as a way to avoid CHD. However, the evidence from individual randomized controlled trials that have studied CHD events (such as heart attacks and CHD-related deaths) have been mixed and could not support this recommendation.

Furthermore, dietary recommendations to reduce SFA have generally not specified any replacement, i.e., whether SFA should be replaced with carbohydrate, protein, or unsaturated fats.

Because of their beneficial effects on blood LDL-C and HDL-C levels, PUFA could be one important replacement for SFA, but, surprisingly, some experts argue that eating PUFA could actually increase CHD risk. 

Consequently, some guidelines recommend that PUFA consumption should be limited or even reduced. In this systematic review (a study that uses predefined criteria to identify all the research on a specific topic) and meta-analysis (a statistical method for combining the results of several studies) of randomized controlled trials, the researchers assess the impact of increased PUFA consumption as replacement for SFA on CHD events.

What Did the Researchers Do and Find?

The researchers' search of the published literature, “grey” literature (doctoral dissertations, technical reports, and other documents not printed in books and journals), and contacts with relevant experts identified eight trials in which participants were randomized to increase their PUFA intake for at least a year and in which CHD events were reported. 1,042 CHD events were recorded among the 13,614 participants enrolled in these trials.

In their meta-analysis, the researchers found that on average the consumption of PUFA accounted for 14.9% of total energy intake in the intervention groups compared with only 5% of total energy intake in the control groups.

Participants in the intervention groups had a 19% reduced risk of CHD events compared to participants in the control groups. Put another way, each 5% increase in the proportion of energy obtained from PUFA reduced the risk of CHD events by 10%. Finally, the researchers found that the benefits associated with PUFA consumption increased with longer duration of the trials.

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