Diet’s Role In Lowering Risk of Repeat Heart Attacks 

By JENNIFER CORBETT DOOREN 

Updated December 3, 2012, 6:42 p.m. ET

Patients with heart disease frequently assume that medication is enough to forestall a repeat heart attack or stroke, but a large new study shows the preventive power of a healthy diet.

Diet Colors: The American Heart Association advises eating vegetables of various colors.

The findings from a report, released Monday, looked at the impact of diet in addition to the medicines routinely used to treat cardiovascular disease. Although it is widely accepted that healthy diets are powerful tools to prevent cardiovascular disease, less is known about the impact of diet on people who already have the disease.

People with the healthiest diets—those with the highest intakes of fruit, vegetables, whole grains, nuts, and a higher intake of fish relative to meat poultry and eggs—were 35% less likely to die from a repeat heart attack or stroke during the length of the study, compared with those with the least healthy diets, according to the five-year study of 32,000 people in 40 countries.

They also were 28% less likely to develop congestive heart failure, 14% less likely to have an additional heart attack and 19% less likely to have a stroke.  (link to rest of article)

Patients in the new study, published in the American Heart Association’s medical journal Circulation, previously participated in two studies designed to look at certain medicines used to treat high blood pressure.

“At times, patients don’t think they need to follow a healthy diet, since their medications have already lowered their blood pressure and cholesterol—that is wrong,” said Mahshid Dehghan, a study author and a nutritionist at the Population Health Research Institute, McMaster University in Hamilton, Ontario. “The more healthy you eat, the healthier you are.”

The drug and diet studies were funded by the German pharmaceutical company Boehringer Ingelheim.

Study participants were at least age 55 or older and had a prior history of heart disease, stroke or had Type 2 diabetes that was severe enough to have damaged organs.

The goal of the diet research was to see whether healthier diets had any impact on the rate of cardiovascular events such as heart attacks and strokes.

Participants in the diet-portion of the studies were followed for almost five years.

Dr. Dehghan explained that researchers used two diet indexes to measure diet quality and to rank people into five groups according to the healthiest to least-healthy diet.

People were asked how often they consumed dairy, meat, fish, fruits and vegetables. They were also asked about consumption of fried foods and whole grains. Portion sizes weren’t recorded.

Researchers controlled for other factors that can influence the progression of cardiovascular disease such as weight, exercise and smoking.

However, Steven Nissen, chairman of the cardiovascular medicine department at the Cleveland Clinic, said that while eating healthy is a good idea, the study itself “doesn’t prove anything.” Dr. Nissen said people with the healthiest diets are more likely to practice other healthy habits such as exercise and said the study authors “cannot adjust for all of these other known and unknown behaviors.”

Dr. Dehghan said researchers also looked at diet quality and the risk for other things, such as cancer, fractures and non-heart related hospitalizations and didn’t find any associations related to diet.

Heart disease is the top killer of Americans, according to the American Heart Association.

The group considers a heart-healthy diet to include more than four cups of fruits and vegetables, and at least three servings of whole grains daily, in addition to limiting intake of sodium and sugar-sweetened beverages.

At least two servings of fish and four servings of nuts or seeds are recommended each week, along with limiting processed meat to no more than two servings a week.

Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com

A version of this article appeared December 3, 2012, on page D1 in the U.S. edition of The Wall Street Journal, with the headline: Diet’s Role In Lowering Risk of Repeat Heart Attacks.

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

Posted March 22, 2010; 10:00 a.m.by Hilary Parker

A Princeton University research team has demonstrated that all sweeteners are not equal when it comes to weight gain: Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same. 

In addition to causing significant weight gain in lab animals, long-term consumption of high-fructose corn syrup also led to abnormal increases in body fat, especially in the abdomen, and a rise in circulating blood fats called triglycerides. The researchers say the work sheds light on the factors contributing to obesity trends in the United States.

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

Posted March 22, 2010; 10:00 a.m. 

by Hilary Parker

  A Princeton University research team has demonstrated that all sweeteners are not equal when it comes to weight gain: Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same. 

In addition to causing significant weight gain in lab animals, long-term consumption of high-fructose corn syrup also led to abnormal increases in body fat, especially in the abdomen, and a rise in circulating blood fats called triglycerides. The researchers say the work sheds light on the factors contributing to obesity trends in the United States.

Some people have claimed that high-fructose corn syrup is no different than other sweeteners when it comes to weight gain and obesity, but our results make it clear that this just isn’t true, at least under the conditions of our tests,” said psychology professor Bart Hoebel, who specializes in the neuroscience of appetite, weight and sugar addiction. “When rats are drinking high-fructose corn syrup at levels well below those in soda pop, they’re becoming obese — every single one, across the board. Even when rats are fed a high-fat diet, you don’t see this; they don’t all gain extra weight.”

A Princeton University research team, including (from left) undergraduate Elyse Powell, psychology professor Bart Hoebel, visiting research associate Nicole Avena and graduate student Miriam Bocarsly, has demonstrated that rats with access to high-fructose corn syrup — a sweetener found in many popular sodas — gain significantly more weight than those with access to water sweetened with table sugar, even when they consume the same number of calories. The work may have important implications for understanding obesity trends in the United States. (Photo: Denise Applewhite) Photos for news media

In results published online Feb. 26 by the journal Pharmacology, Biochemistry and Behavior, the researchers from the Department of Psychology and the Princeton Neuroscience Institute reported on two experiments investigating the link between the consumption of high-fructose corn syrup and obesity.

The first study showed that male rats given water sweetened with high-fructose corn syrup in addition to a standard diet of rat chow gained much more weight than male rats that received water sweetened with table sugar, or sucrose, in conjunction with the standard diet. The concentration of sugar in the sucrose solution was the same as is found in some commercial soft drinks, while the high-fructose corn syrup solution was half as concentrated as most sodas.

The second experiment — the first long-term study of the effects of high-fructose corn syrup consumption on obesity in lab animals — monitored weight gain, body fat and triglyceride levels in rats with access to high-fructose corn syrup over a period of six months. Compared to animals eating only rat chow, rats on a diet rich in high-fructose corn syrup showed characteristic signs of a dangerous condition known in humans as the metabolic syndrome, including abnormal weight gain, significant increases in circulating triglycerides and augmented fat deposition, especially visceral fat around the belly. Male rats in particular ballooned in size: Animals with access to high-fructose corn syrup gained 48 percent more weight than those eating a normal diet.

“These rats aren’t just getting fat; they’re demonstrating characteristics of obesity, including substantial increases in abdominal fat and circulating triglycerides,” said Princeton graduate student Miriam Bocarsly. “In humans, these same characteristics are known risk factors for high blood pressure, coronary artery disease, cancer and diabetes.” In addition to Hoebel and Bocarsly, the research team included Princeton undergraduate Elyse Powell and visiting research associate Nicole Avena, who was affiliated with Rockefeller University during the study and is now on the faculty at the University of Florida. The Princeton researchers note that they do not know yet why high-fructose corn syrup fed to rats in their study generated more triglycerides, and more body fat that resulted in obesity. 

When male rats were given water sweetened with high-fructose corn syrup in addition to a standard diet of rat chow, the animals gained much more weight than male rats that received water sweetened with table sugar, or sucrose, along with the standard diet. The concentration of sugar in the sucrose solution was the same as is found in some commercial soft drinks, while the high-fructose corn syrup solution was half as concentrated as most sodas, including the orange soft drink shown here. (Photo: Denise Applewhite)

High-fructose corn syrup and sucrose are both compounds that contain the simple sugars fructose and glucose, but there at least two clear differences between them. First, sucrose is composed of equal amounts of the two simple sugars — it is 50 percent fructose and 50 percent glucose — but the typical high-fructose corn syrup used in this study features a slightly imbalanced ratio, containing 55 percent fructose and 42 percent glucose. Larger sugar molecules called higher saccharides make up the remaining 3 percent of the sweetener. Second, as a result of the manufacturing process for high-fructose corn syrup, the fructose molecules in the sweetener are free and unbound, ready for absorption and utilization. In contrast, every fructose molecule in sucrose that comes from cane sugar or beet sugar is bound to a corresponding glucose molecule and must go through an extra metabolic step before it can be utilized.

This creates a fascinating puzzle. The rats in the Princeton study became obese by drinking high-fructose corn syrup, but not by drinking sucrose. The critical differences in appetite, metabolism and gene expression that underlie this phenomenon are yet to be discovered, but may relate to the fact that excess fructose is being metabolized to produce fat, while glucose is largely being processed for energy or stored as a carbohydrate, called glycogen, in the liver and muscles.

In the 40 years since the introduction of high-fructose corn syrup as a cost-effective sweetener in the American diet, rates of obesity in the U.S. have skyrocketed, according to the Centers for Disease Control and Prevention. In 1970, around 15 percent of the U.S. population met the definition for obesity; today, roughly one-third of the American adults are considered obese, the CDC reported. High-fructose corn syrup is found in a wide range of foods and beverages, including fruit juice, soda, cereal, bread, yogurt, ketchup and mayonnaise. On average, Americans consume 60 pounds of the sweetener per person every year.

Breastfeeding: National Institute of Child Health and Human Development

What Is Breastfeeding?

Breastfeeding, also called nursing, can be an easy and inexpensive way for a mother to feed her child.

According to the Policy Statement on Breastfeeding from the American Academy of Pediatrics (AAP), women who don’t have health problems should exclusively breastfeed their infants for at least the first six months of life. The AAP also suggests that women try to breastfeed for the first 12 months of life because of the benefits to both the mother and baby.

What Is Breastfeeding?

Breastfeeding, also called nursing, can be an easy and inexpensive way for a mother to feed her child.

According to the Policy Statement on Breastfeeding from the American Academy of Pediatrics (AAP), women who don’t have health problems should exclusively breastfeed their infants for at least the first six months of life. The AAP also suggests that women try to breastfeed for the first 12 months of life because of the benefits to both the mother and baby.

What Are the Benefits of Breastfeeding?

Breastfeeding offers many benefits to the baby:

• ·Breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler.
• ·Breastfed infants, and those who are fed expressed breast milk, have fewer deaths during the first year and experience fewer illnesses than babies fed formula.
• ·Some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, such as diarrhea, middle ear infections, and certain lung infections.
• ·Recent research supported by the National Institute of Child Health and Human Development (NICHD) also suggests that breast milk contains important fatty acids (building blocks) that help an infant’s brain develop. Two specific fatty acids, known as DHA and AA, may help increase infants’ cognitive skills. (Many types of infant formula are fortified with DHA and AA, and all formulas for preterm infants are fortified with these fatty acids.)

Breastfeeding also benefits the mother:

• ·In response to the baby’s sucking, the mother’s body releases a hormone that makes her uterus contract and get smaller.
• ·Many mothers also get emotional benefits from breastfeeding because of the closeness of this interaction with the baby and the satisfaction of helping to nourish him or her.
• ·Some research suggest that mothers who breastfeed their babies have fewer episodes of post-delivery depression.
• ·There is evolving evidence to indicate that certain types of cancer (such as breast, uterus, and ovarian cancer) occur less often in mothers who have breastfed their babies.

Many societies and cultures encourage mothers to breastfeed, which can offer support to a new mother.

What if I Have Trouble Breastfeeding?

Even though breastfeeding is a natural process, it’s not always easy. Many health care providers suggest that women work with a lactation counselor (also known as a lactation consultant) or lactation specialist to learn how to breastfeed and what is involved with breastfeeding. Many health centers, clinics, and hospitals have lactation counselors on staff. Ask your health care provider for more information about getting help with breastfeeding. Even with help, though, some women still have trouble breastfeeding or cannot breastfeed.

Are There Cases in Which it Is Better Not to Breastfeed?

In certain situations, health care providers may advise a woman not to breastfeed:

• ·A woman with certain health conditions, such as HIV or active tuberculosis, should not breastfeed because she risks giving the infection to her infant through her breast milk.
• ·Women who actively use drugs or do not control their alcohol intake, or who have a history of these situations, may also be advised not to breastfeed.
• ·Certain medicines, including some mood stabilizers and migraine medicines, can also pass through the breast milk and cause harm to the infant.
• ·Women with certain chronic illnesses may be advised not to breastfeed, or to take special steps to ensure their own health while breastfeeding. For example, women who have diabetes may need to eat slightly more food while they breastfeed, to prevent their blood sugar levels from dropping.
• ·Women who have had breast surgery in the past may face some difficulties in breastfeeding.

Please note: engorgement, hardening of the breast, “breast abscess,” fever, and use of pain medications or antibiotics are NOT reasons to stop breastfeeding. In fact, in some cases-such as breast abscess or breast hardening-emptying of the breast helps to relieve the problem.

If you have any health conditions, or you are taking any medications or over-the-counter supplements, you should discuss breastfeeding with your health care provider.

After Breastfeeding

If a mother stops breastfeeding before the child is a year old, then she should feed her infant iron-fortified, commercially available formula. Health care providers advise women not to give their infant cow’s milk until the child is at least a year old.

Source: National Institute of Child Health and Human Development

  Artificial sweeteners: sugar-free, but at what cost?

Posted July 16, 2012, 1:28 pm   Holly Strawbridge, Executive Editor, Harvard Heart Letter

By offering the taste of sweetness without any calories, artificial sweeteners seem like they could be one answer to effective weight loss. The average 12-ounce can of sugar-sweetened soda delivers about 150 calories, almost all of them from sugar. The same amount of diet soda—zero calories. The choice seems like a no-brainer.

The American Heart Association (AHA) and American Diabetes Association (ADA) have given a cautious nod to the use of artificial sweeteners in place of sugar to combat obesity, metabolic syndrome, and diabetes, all risk factors for heart disease. (You can read the full statement here.)

“While they are not magic bullets, smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat. Reducing calories could help you attain and maintain a healthy body weight, and thereby lower your risk of heart disease and diabetes,” said Dr. Christopher Gardner, an associate professor of medicine at Stanford University in California, in a press release accompanying the scientific statement.

As with everything, there’s more to the artificial sweetener story than their effect on weight. To learn more about them, I spoke with Dr. David Ludwig, an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital. He has a keen interest in products designed to help people lose weight at keep it off. And what he has learned about artificial sweeteners worries him. 

All sweeteners are not created equal

The FDA has approved five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved one natural low-calorie sweetener, stevia. How the human body and brain respond to these sweeteners is very complex.

One concern is that people who use artificial sweeteners may replace the lost calories through other sources, possibly offsetting weight loss or health benefits, says Dr. Ludwig. This can happen because we like to fool ourselves: “I’m drinking diet soda, so it’s okay to have cake.” The AHA and ADA also added this caveat to their recommendation.

It’s also possible that these products change the way we taste food. “Non-nutritive sweeteners are far more potent than table sugar and high-fructose corn syrup. A miniscule amount produces a sweet taste comparable to that of sugar, without comparable calories. Overstimulation of sugar receptors from frequent use of these hyper-intense sweeteners may limit tolerance for more complex tastes,” explains Dr. Ludwig. That means people who routinely use artificial sweeteners may start to find less intensely sweet foods, such as fruit, less appealing and unsweet foods, such as vegetables, downright unpalatable.

In other words, use of artificial sweeteners can make you shun healthy, filling, and highly nutritious foods while consuming more artificially flavored foods with less nutritional value.

Artificial sweeteners may play another trick, too. Research suggests that they may prevent us from associating sweetness with caloric intake. As a result, we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight. Participants in the San Antonio Heart Study who drank more than 21 diet drinks per week were twice as likely to become overweight or obese as people who didn’t drink diet soda.

But you say you can give up diet drinks whenever you want? Don’t be so sure. Animal studies suggest that artificial sweeteners may be addictive. In studies of rats who were exposed to cocaine, then given a choice between intravenous cocaine or oral saccharine, most chose saccharin.

What’s your definition of safe?

Whether non-nutritive sweeteners are safe depends on your definition of safe. Studies leading to FDA approval have ruled out cancer risk, for the most part. However, those studies were done using far smaller amounts of diet soda than the 24 ounces a day consumed by many people who drink diet soda. We really don’t know what effect large amounts of these chemicals will have over many years.

And there are other health concerns beside cancer. In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes. Aren’t these diseases that artificial sweeteners may help prevent in the first place?

Back to sugar?

Maybe sugar isn’t too bad after all. It’s all in how it’s packaged.

“Sugar-containing foods in their natural form, whole fruit, for example, tend to be highly nutritious—nutrient-dense, high in fiber, and low in glycemic load. On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels, increases triglycerides, inflammatory mediators and oxygen radicals, and with them, the risk for diabetes, cardiovascular disease and other chronic illnesses,” Dr. Ludwig explains.

I think I’ll have a glass of water and an apple.

Here are storage tips from the Berkeley Farmers Market. Take a look at these ideas for creative and waste-free ways to extend the life of your produce, in and out of the refrigerator.

• Asparagus—Place the upright stalks loosely in an glass or bowl with water at room temperature. Will keep for a week outside the fridge.
• Basil—Difficult to store well. Basil does not like to be cold or wet. The best method here is an airtight container/jar loosely packed with a small damp piece of paper inside, left out on a cool counter.
• Beets—Cut the tops off to keep beets firm, and be sure to keep the greens! Leaving any top on root vegetables draws moisture from the root, making them loose flavor and firmness. Beets should be washed and kept in an open container with a wet towel on top.

• Beet greens—Place in an airtight container with a little moisture from a damp cloth.
• Berries—Don’t forget, they’re fragile. When storing, stack them in a single layer, if possible, in a paper bag. Wash right before you plan on eating them.
• Carrots—Cut the tops off to keep them fresh longer. Place them in closed container with plenty of moisture, either wrapped in a damp towel or dunk them in cold water every couple of days if they’re stored that long.
• Corn—Leave unhusked in an open container if you must, but corn really is best the day it’s picked.
• Greens—Remove any bands, twist ties, etc. Most greens must be kept in an air‐tight container with a damp cloth to keep them from drying out. Kale, collard greens, and chard do well in a cup of water on the counter or fridge.
• Melons—Keep uncut in a cool dry place, out of the sun for up to a couple weeks. Cut melons should be in the fridge; an open container is fine.
• Peaches (and most stone fruit)—Refrigerate only when fully ripe. Firm fruit will ripen on the counter.
• Rhubarb—Wrap in a damp towel and place in an open container in the refrigerator.
• Strawberries—Don’t like to be wet. Do best in a paper bag in the fridge for up to a week. Check the bag for moisture every other day.
• Sweet Peppers—Only wash them right before you plan on eating them as wetness decreases storage time. Store in a cool room to use in a couple of days, place in the crisper if longer storage is needed.
• Tomatoes—Never refrigerate. Depending on ripeness, tomatoes can stay for up to two weeks on the counter. To hasten ripeness, place in a paper bag with an apple.
• Zucchini—Does fine for a few days if left out on a cool counter, even after cut. Wrap in a cloth and refrigerate for longer storage.

EWG’s 2012 Shopper’s Guide to Pesticides in Produce™

Eat your fruits and vegetables! The health benefits of a diet rich in fruits and vegetables outweigh the risks of pesticide exposure. Use EWG’s Shopper’s Guide to Pesticides^™ to reduce your exposures as much as possible, but eating conventionally-grown produce is far better than not eating fruits and vegetables at all. The Shopper’s Guide to Pesticides in Produce^™ will help you determine which fruits and vegetables have the most pesticide residues and are the most important to buy organic. You can lower your pesticide intake substantially by avoiding the 12 most contaminated fruits and vegetables and eating the least contaminated produce.

This year we have expanded the Dirty Dozen^™ with a Plus category to highlight two crops — green beans and leafy greens, meaning, kale and collard greens – that did not meet traditional Dirty Dozen ^™criteria but were commonly contaminated with highly toxic organophosphate insecticides. These insecticides are toxic to the nervous system and have been largely removed from agriculture over the past decade. But they are not banned and still show up on some food crops.

Commodity crop corn used for animal feed and biofuels is almost all produced with genetically modified (GMO) seeds, as is some sweet corn sold for human consumption. Since GMO sweet corn is not labeled as such in US stores, EWG advises those who have concerns about GMOs to buy organic sweet corn.

1

Apples

2

Celery

3

Sweet bell peppers

4

Peaches

5

Strawberries

6

Nectarines
– imported

7

Grapes

8

Spinach

9

Lettuce

10

Cucumbers

11

Blueberries
– domestic

12

Potatoes

+

Green beans

+

Kale/Greens

1

Onions

2

Sweet Corn

3

Pineapples

4

Avocado

5

Cabbage

6

Sweet peas

7

Asparagus

8

Mangoes

9

Eggplant

10

Kiwi

11

Cantaloupe
- domestic

12

Sweet potatoes

13

Grapefruit

14

Watermelon

15

Mushrooms

Avoid sunscreens with potentially harmful ingredients, group warns

 The Truth about Prices at Farmers Markets

 ”You’ve probably heard that buying from farmers markets is more expensive than buying from a grocery store. We want to debunk some of these myths.  More and more research is being done that compares prices at farmers markets with those in grocery stores. And the numbers may surprise you.

 According to research done by the Seattle  Neighborhood Farmers Market Alliance and the results of another study reported by  KOMO News, a Seattle-based news network, certain produce is definitely lower in cost when bought at a market. This was the case for collard greens, which only cost 75 cents a local farmers market compared to a range of $1.33 to $2.49 at other grocery stories. While this may not be the case for all produce, the article estimates an average of 62 cents of savings for a variety of produce compared with grocery store prices.

 Another study by  NOFA Vermont shows that if you’re looking for organic, farmers markets are the place to shop, with some price variation among other, conventionally grown products.   The Leopold Center for Sustainable Agriculture also demonstrated that local prices at farmers markets were often equal to or lower than grocery store prices.

 Being a smart consumer also helps. Just like shopping at a supermarket, there are tips to finding the best deals at a farmers market.

 1. Shop around. Walk the market first and compare prices for the items you are interested in.

 2. Build relationships with standholders. They may offer you a better deal, fill you in on what produce to expect for the next market day, or offer you bumped and bruised produce for a lower cost.

 3. By knowing your farmer, you may be able to forego buying organic only because you know that how they grow those strawberries you’re eyeing up.

 4. A  Business Insider article recommends shopping late in the day or in inclement weather. Vendors are hoping to make their daily quota and by the end of the day, they do not want to take the remainder of their produce back home. Often, prices are reduced by the end of the day.

 5. Remember that the produce you are buying locally will last longer than what you can find in the store. You also are more likely to get the specific amounts you desire (a half a pint of brussel sprouts, a small bunch of grapes) which reduces the amount of waste from having too much of some items.”

 We at Overtime couldn’t believe our ears when we heard this report. We knew sugar was bad, but a “toxin”? We give our kids that stuff!

We weren’t quite sure how to apply the new science in the 60 Minutes report to the challenges of everyday family life, so we sat down with Dr. Sanjay Gupta for some practical advice. Both a doctor and a father of three, Dr. Gupta offers his take on how a typical American family should think about the sugar in their diet.”   View the video here.

Guests

Juleen Zierath
Professor, Clinical Integrative Physiology
Karolinska Institute
Stockholm, Sweden

Related Links

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Segment produced by:Namisha Sarin Anand