Department of Food Science and Human Nutrition

Extension
Colorado State University
Fort Collins, CO 80523-1571

Healthy Heart Beats

April-June 2009
Vol 31, Issue 2

Nutrition and Research Updates

DASH Diet an Advantage for Women's Health

heart beat "The Dietary Approaches to Stop Hypertension (DASH) diet may contribute to prevention of heart failure in some cases because it effectively reduced blood pressure and low-density lipoprotein (LDL, or "bad") cholesterol levels in clinical trials," wrote Emily B. Levitan, of Beth Israel Deaconess Medical Center in Boston, and colleagues. "This diet features high intake of fruits, vegetables, low-fat dairy products and whole grains, resulting in high potassium, magnesium, calcium and fiber consumption, moderately high protein consumption, and low total fat and saturated fat consumption," the authors added.

The study included an analysis of data from 36,019 Swedish women, aged 48 to 83, who did not have baseline heart failure. These women, also, completed a questionnaire about their eating habits. A DASH diet frequency score was created to assess consistency with the DASH diet. The 25 percent of women with the highest DASH diet scores had a 37 percent lower rate of heart failure than the 25 percent of women with the lowest DASH diet scores, the researchers found. The rate of heart failure of women in the top 10 percent of DASH diet scores was 50 percent of those with the lowest DASH diet scores.

Previous research has shown that the DASH diet cuts systolic (top number) blood pressure by about 5.5 mm Hg, a decrease that could lower the rate of heart failure an estimated 12 percent, Levitan noted in a news release from the journal.

Source: Archives of Internal Medicine,, 2009, 169(9):851-857 (May).

Salt Intake Too High Among Americans

salt Adults in the United States consume more than twice the recommended amount of salt, raising their risk for high blood pressure, heart attacks and strokes. According to a 2005-2006 Centers for Disease Control (CDC) estimate 29 percent of adults had hypertension; 28 percent had prehypertension. Over 69 percent of U.S. adults met the criteria for the risk groups (including African-Americans and those over the age of 40) recommended to lower sodium consumption to less than1,500 mg per day.

Recommendations to stay within recommended limits include:

Trim serving sizes.
Eat less processed food high in sodium (not limited to salty foods).
Check nutrition labels to limit or avoid high sodium foods.
Recognize that restaurant and fast foods tend to be high in sodium.

"It's important for people to eat less salt. People who adopt a heart-healthy eating pattern that includes a diet low in sodium and rich in potassium and calcium can improve their blood pressure," Dr. Darwin Labarthe of the CDC said in a statement. "People need to know their recommended daily sodium limit and take action to reduce sodium intake," Labarthe said. The 2005 Dietary Guidelines for Americans recommend that healthy adults should consume less than 2,300 mg of sodium or about one teaspoon of salt per day.

The CDC said it will join other agencies in the Health and Human Services department in working with major food manufacturers and chain restaurants to reduce sodium levels in the food supply. For more information visit the Web site of the Division of Heart Disease and Stroke Prevention: www.cdc.gov/dhdsp.

Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5811a2.htm [March 27, 2009 / 58(11); 281-283]; http://www2a.cdc.gov/podcasts/player.asp?f=11112

Sweetened Beverages Linked to Women’s Heart Disease Risk

In addition to weight gain and an increased risk of type 2 diabetes, drinking sweetened beverages has now been linked to a higher risk of coronary heart disease (CHD). “We found that consumption of sugar-sweetened beverages is associated with a higher risk of CHD in women, even after other risk factors for CHD or an unhealthful diet or lifestyle are accounted for. This finding provides further rationale for limiting the consumption of sugar-sweetened beverages,” wrote lead author Teresa Fung from Simmons College in Boston and Harvard Medical School.

The study evaluated data from 88,520 women between 34 and 59 years of age participating in the Nurses' Health Study. The women were free of CHD, stroke, or diabetes at the start of the study in 1980. Food-frequency questionnaires were used to evaluate dietary habits.

During 24 years of follow-up Dr. Fung and her research team documented 3,105 incident cases of both non-fatal myocardial infarction and fatal CHD. After adjusting the data for other factors including but not limited to body mass index and energy intake, the researchers found that consuming two or more servings of sugar-sweetened beverages per day was associated with a 35 per cent increase in the risk of CHD.

cola Commenting on the possible mechanism, the researchers said: “Fructose has been the major sweetener in sugar-sweetened beverages since the mid-1980s, and it increases triacylglycerol synthesis in the liver, which results in elevated triacylglycerol concentrations, which have been associated with a greater risk of CHD. Fructose is also the only sugar that can increase blood uric acid concentrations. High uric acid concentrations may reduce endothelial nitric oxide, which could partly mediate a relation between soft drink consumption and risk of CHD.”

The researchers defined sweetened beverages as “caffeinated and non-caffeinated colas, other carbonated beverages with sugar, and non-carbonated sweetened beverages.” Artificially sweetened beverages were defined as “all types of low-calorie sweet carbonated beverages, such as diet colas and other diet carbonated beverages.” The researchers noted that artificially sweetened beverages were not associated with CHD risk.

Source: American Journal of Clinical Nutrition,, 2009, 89(4):1037–1042 (April).

Daily Red Meat Consumption Linked to Mortality

In the first large study which addressed the link between eating red and processed meat and mortality, researchers concluded eating red meat (beef and/or pork) and processed meat were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality. "The bottom line is we found an association between red meat and processed meat and an increased risk of mortality," said Rashmi Sinha of the National Cancer Institute, who led the study.

More than half a million middle-aged and elderly Americans aged 50 to 71 in the National Institutes of Health–AARP Diet and Health Study filled out diet questionnaires. After accounting for other variables that might confound the findings, such as smoking, physical activity, family history and fruit and vegetable consumption, the researchers found that those who ate about four ounces of red meat daily were more than 30 percent (36 percent for women; 31 percent for men) likely to die from any cause than those who ate the least red meat. The risk of dying from cancer increased 20 percent (20 for women; 22 for men). The largest disparity among women and men was in the risk for dying from heart disease (50 percent for women and 27 percent for men).

hot dog The risk of dying also rose among those who consumed the most processed meat (sausage, cold cuts or hot dogs). Women who consumed the most processed meat (about an ounce a day) were about 25 percent more likely to die overall, about 11 percent more likely to die of cancer and about 38 percent more likely to die from heart disease, compared to those who ate the least. The men who ate the most processed meat were 16 percent more likely to die for any reason, about 12 percent more likely to die of cancer and about 9 percent more likely to die of heart disease.

However, regular consumption of fish and poultry decreased the risk of death. Those who consumed the most white meat were about 8 percent less likely to die during the study period than those who ate the least, the researchers found. The researchers noted that poultry contains more unsaturated fat, which improves cholesterol levels, and fish contains omega-3 fatty acids, which are believed to help reduce the risk of heart disease. "The uniqueness of this study is its size and length of follow-up," said Barry M. Popkin, a professor of global nutrition at the University of North Carolina, who wrote an editorial accompanying the study. "This is a slam-dunk to say that, 'Yes, indeed, if people want to be healthy and live longer, consume less red and processed meat.'"

"The take-home message is pretty clear," said Walter Willett, a nutrition expert at the Harvard School of Public Health. "It would be better to shift from red meat to white meat such as chicken and fish, which if anything is associated with lower mortality." The mechanism for the link between heightened mortality and frequent consumption of red meat and processed meat is not entirely understood. However, experts suggest that the findings do not mean people need to eliminate red meat and processed meat from their diet, but instead should eat it less frequently and eat smaller portions.

Source: Archives of Internal Medicine,, 2009, 169(6):562-571 (March).

Total Calories Most Important when “Dieting”

A two-year National Institutes of Health (NIH)-funded study assigned 811 overweight people to one of four reduced-calorie diets. The researchers concluded that the total number of calories consumed was most critical to weight loss regardless of percent calories from fat, protein, and carbohydrate in the diet. This study "really goes against the idea that certain foods are the key to weight loss," says Frank Sacks, principal investigator and a professor of cardiovascular-disease prevention at Harvard School of Public Health. "This is a pretty positive message. It gives people a lot of choices to find a diet they can stick with."

Study participants followed one of four low-calorie diets. Two of the diets were low fat and two were high fat, and each of these included either a high-protein or an averageprotein component. The percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65 percent; 20, 25, and 55 percent; 40, 15, and 45 percent; and 40, 25, and 35 percent. The diets consisted of similar foods and met guidelines for cardiovascular health. Participants were asked to exercise a fixed 90 minutes a week and were offered group and individual counseling sessions for two years.

inches Participants who attended counseling sessions lost an average of 13 pounds after six months. They began to regain weight after 12 months. After two years 80 percent of the participants who remained in the study had lost nine pounds on average and trimmed two inches off their waists regardless of which diet they followed. Attendance was strongly linked to weight loss. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets. The diets improved lipid-related risk factors and fasting insulin levels.

The message is that dieting may be "much simpler" than everyone thought, says Catherine Loria, a nutritional epidemiologist at the NIH and co-author of the study. Along with choosing healthful foods, "all you have to do is count your calories."

In the NIH study participants used a Web-based, self-monitoring tool that tracked how their daily food intake met their calorie goals. Debbie Mayer, of Brockton, Mass., says this helped her stay disciplined. "I'd just see the numbers and say, 'I can't eat anymore today.'"

In an editorial accompanying the New England Journal of Medicine report, Martijn Katan, a nutrition researcher at Amsterdam's VU University, noted that participants had waning success keeping off weight toward the end of the study, suggesting their discipline began slipping. "Evidently, individual treatment is powerless against an environment that offers so many high-calorie foods and labor-saving devices," he said.

Source: New England Journal of Medicine,, 2009, 360(9):859-873 (February).

Palm Oil an Unhealthy Substitute for Trans Fats

Food labels must state the amount of trans fatty acids, a known factor in heart disease risk, in packaged foods. A recent study has investigated whether palm oil would be a good substitute for partially hydrogenated fat in manufactured foods.

Fifteen adults over the age of 50 with elevated LDL “bad” cholesterol, both male and female, volunteered for the study. Each participant consumed each of four 35-day experimental diets. The fats tested were partially hydrogenated soybean oil (moderately high in trans fat), palm oil (high in saturated fat), canola oil (high in monounsaturated fat), and soybean oil (high in polyunsaturated fat).

oil The findings suggest that consuming either increased levels of partially hydrogenated soybean oil or palm oil as part of a diet would result in similar unfavorable levels of LDL “bad” cholesterol and apolipoprotein B (a protein, attached to fat particles, that carries bad cholesterol throughout the bloodstream). However, the diets enriched with canola or soybean oils, high in monounsaturated and polyunsaturated fats, respectively, did not yield similar unfavorable results.

The authors concluded the results suggest that palm oil would not be a good substitute for trans fats by the food industry. Lead scientist Alice H. Lichtenstein and colleagues conducted the study. She is with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston, Mass.

Source: Agricultural Research Magazine,, 2009, 57(4):22 (April).

Dietary Supplement Ingredient Database

The Nutrient Data Laboratory , Beltsville Human Nutrition Research Center , part of the USDA Agricultural Research Service, working with the Office of Dietary Supplements, NIH, and other federal agencies, has developed a Dietary Supplement Ingredient Databases (DSID) to estimate levels of ingredients in dietary supplement products.

This first data release of the DSID (DSID-1) provides access to information on analyzed levels of nutrients in adult multivitamin/minerals (MVMs) used in the U.S. These estimates were derived from analytical data generated for a representative set of adult MVM products collected from various U.S. locations. At this time, the DSID is intended primarily for research applications. These data are appropriate for conducting population studies of nutrient intake, rather than for assessing individual products. Since over half of American adults report taking a dietary supplement, the estimates in the DSID will improve assessment of total nutrient intake from foods and supplements. To access DSID-1, go to: http://dietarysupplementdatabase.usda.nih.gov.

Source: http://www.ars.usda.gov/is/pr/2009/090420.htm (Agricultural Research Service; April 20, 2009)

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