The Centers for Disease Control and Prevention (CDC) reports that heart disease is “the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.”  In fact, one person dies every 36 seconds in the United States from heart disease, leading to about 659,000 deaths each year.

Studies have shown that nutrition plays a key role in the development or prevention of heart disease.  According to the World Health Organization, “most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.”

While poor nutrition has been linked to the development and progression of heart disease, good nutrition has been linked to the prevention and management of heart disease.  ASN Journals have been at the forefront of research exploring the relationship between nutrition and heart disease for decades, providing the underlying science needed to inform public health guidelines as well as individualized nutrition plans for patients.  Below are a sampling of original research studies and scientific reviews recently published in ASN Journals that help us better understand the role of nutrition in both the development and treatment of heart disease.

Eating Pattern Response to a Low-Fat Diet Intervention and Cardiovascular Outcomes in Normotensive Women: The Women’s Health Initiative,” Current Developments in Nutrition, March 2020

  • The Women’s Health Initiative Diet Modification Trial was a randomized clinical trial of 48,835 postmenopausal women in the United States that sought to determine whether a low-fat dietary pattern (20% of total calories from fat) that included five servings of fruits and vegetables and six servings of grains per day would reduce the incidence of breast cancer and colorectal cancers.  Coronary heart disease was the designated secondary outcome.  In this particular study, ASN member Linda Van Horn et al. focused on how the low-fat diet affected cardiovascular disease risk among women with healthy blood pressure and no history of cardiovascular disease.  Previous study results had found that the effect of the low-fat diet among women with high blood pressure and a history of cardiovascular disease was confounded by the use of antihypertensive and cholesterol-lowering medications.  Focusing on the normotensive women, the authors found that “a behaviorally focused dietary intervention advocating reduction of total fat intake through replacement with plant-based carbohydrate and protein foods favorably reduced risk of coronary heart disease with no clear stroke impact.”

Glycemic Index, Glycemic Load, and Risk of Coronary Heart Disease: A Pan-European Cohort Study,” The American Journal of Clinical Nutrition, September 2020

  • Do high glycemic index foods lead to a higher risk of heart disease?  To answer that question, Sabina Sieri et al. analyzed data from the European Prospective Investigation into Cancer and Nutrition, a prospective study that consisted of 338,325 participants who had completed a food questionnaire at baseline.  Following a median follow-up period of 12.8 years in which participants’ health status was periodically assessed, the authors concluded, “high dietary glycemic load and glycemic index were associated with greater coronary heart disease risk.”  In particular, the authors noted that “body weight may serve as an effect modifier on this association.”  For example, they found that dietary glycemic load (i.e., how much a serving of food is likely to increase a person’s blood sugar levels) was significantly associated with a greater coronary heart disease risk among overweight and obese persons, but not among those in a healthy weight range.  The authors did note a limitation of the study: “most people do not eat single foods, but rather meals, and a food’s glycemic index can vary depending on how it is prepared and combined with other foods.  It is not possible to take such interactions into account using a food questionnaire.”

Adherence to the Healthy Eating Index-2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality,” The Journal of Nutrition, February 2020

  • Emily A. Hu et al. wanted to know whether adherence to the Healthy Eating Index-2015, as well as adherence to the Alternative Healthy Eating Index-2010, alternate Mediterranean diet, and Dietary Approaches to Stop Hypertension (DASH), had an effect on the incidence of cardiovascular disease, cardiovascular disease mortality, and all-cause mortality.  To conduct their research, the authors worked with data from 12,413 men and women aged 45-64 years at baseline who participated in the Atherosclerosis Risk in Communities Study.  This study was launched in 1987 and is ongoing, with a median of 24 to 25 years of follow-up.  Following their analysis, the authors found that adherence to all four dietary patterns was associated with a lower incidence of cardiovascular disease, cardiovascular disease mortality, and all-cause mortality, although adherence to DASH led to slightly weaker associations.  “The strongest associations were observed for cardiovascular disease mortality, in which the highest adherence (quintile 5) to the healthy dietary patterns was associated with 21-34% reductions in risk, compared to participants with the lowest adherence (quintile 1).”

Whole-Fat or Reduced-Fat Dairy Product Intake, Adiposity, and Cardiometabolic Health in Children: A Systematic Review,” Advances in Nutrition, July 2020

  • Dietary Guidelines for Americans, 2020-2025 recommends that children and adolescents consume reduced-fat dairy products rather than whole-fat dairy to reduce their risk of obesity and cardiometabolic diseases.  Among adults, however, most studies have found that whole-fat dairy is not associated with increased cardiometabolic or obesity risk.  Therese A. O’Sullivan et al. wanted to know if this association also held true for children. To conduct their review, the authors reviewed studies of children aged 2 to 18 years that explored the associations between whole- and reduced-fat dairy intake and measures of adiposity as well as biomarkers of cardiometabolic disease risk, including serum lipid profile, blood pressure, low-grade chronic inflammation, oxidative stress, and glucose homeostasis.  According to the findings, “most evidence indicated that consumption of whole-fat dairy was not associated with increased cardiometabolic risk.” The authors did, however, note that not all studies reported consistent results, pointing to one study that found a change from whole-fat to reduced-fat dairy did improve some cardiometabolic risk factors, including HDL cholesterol. “Taken as a whole, the limited literature in this field is not consistent with dietary guidelines recommending that children consume preferably reduced-fat dairy products.”

If you are conducting research in the area of nutrition and heart health, please consider submitting your important findings to an ASN Journal.  There’s never been a better time to publish with ASN: Our Board of Directors has recently committed to a strategic roadmap that, among many goals, is improving the ease and speed of publishing with ASN as well as improving the discoverability of your journal content.