Eat like a Greek, say heart experts
April 13, 2009
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Joseph Hall
HEALTH REPORTER
It's a study that's sure to be well received on Toronto's Danforth Ave.
A McMaster University paper released today says that if you want to ensure your food choices are healthy for your heart there's at least one, can't-miss diet approach.
Eat Greek.
The study, which examined almost 60 years worth of existing research on diet and heart disease, attempts to separate the whole wheat from the chaff on foods in a way that doctors and consumers can swallow with confidence, says Dr. Sonia Anand, the study's senior author.
Appearing in the journal Archives of Internal Medicine, the study touts a Mediterranean diet as having sure-fire heart healthy properties.
"It's the best that we can do yet," Anand, a professor of medicine and epidemiology at the Hamilton school, says of the study's food and heart link findings.
While consumers may feel they read conflicting diet news all the time, she says people can be more confident in this comprehensive study's conclusions than in any research previously produced.
And the evidence — skyrocketing obesity rates and increasing incidence of heart disease and Type 2 diabetes, for example — overwhelmingly suggests that the practice of shunning fatty meats and processed foods for plates rich in vegetables and whole grains has not been widely adopted here.
While the study's list of foods that protect the heart contains few surprises, researchers found little evidence to support the claims of some highly touted diets and supplements.
"One area that we did not find overwhelmingly strong evidence for would be the Omega-3 fatty acids," says Anand. Those coming from fish seem to
be heart protective, while those that come from plant sources like
walnuts and flax seed have little in the research to support them.
As well, she says, while vitamin E and C supplements are widely used as heart support systems, there's little evidence that they work that way.
"Certainly a large number of people go out, buy the supplements and take them hoping that they are preventing some sort of chronic disease be it heart disease or cancer," Anand says.
Yet while there is "moderate" evidence that eating these vitamins in fruits or vegetables has some protective properties, there's almost none that they are beneficial in pill form.
"The supplements have not panned out, they have not been associated with a lower heart disease risk and in some cases have been associated with a higher cancer risk," Anand says.
She says the beneficial effects seen from vitamins eaten in fruits and vegetables likely come from some innate nutritional properties in the plants themselves.
"We've tried to tease (the beneficial properties) out and put them in a bottle, but we haven't been successful."
Generally speaking heart-friendly foods include such familiar fare as vegetables, nuts and Mediterranean dishes like simple salads made with tomato and cucumber.
Indeed the Mediterranean diet is one Greek gift that every heart should welcome as an honest shield against coronary ailments, Anand says.
Typically it would include healthy portions of tomatoes and other vegetables, fruits, almonds, whole grain breads and mono unsaturated fat products like avocados, feta cheese and olive oil.
"First off we say 'picture what the southern Italians and the Greeks are eating'," Anand says.
"Picture taking a whole grain piece of bread...dipping it in olive oil with a bit of feta cheese and some tomato as the typical kind of lunch you might eat in Greece."
Anand says her study shows with greater than 90 per cent certainty that such a diet would be good for the heart.
Again, Anand says, it would surprise few that such meals are heart healthy.
"But what we were able to do is really say 'Yep, the evidence in the field supports those beliefs so those are the things that physicians and dieticians should counsel...and the media should promote."
The line up of foods found to be harmful to the heart also contains some usual suspects, including trans fats, sugary-laden confections and diets heavy on processed foods, red meat, butter and dairy products.
In other words — a typical Western diet.
"It's not coming up as being very beneficial on a number of fronts," Anand says of the way North Americans typically eat.
"The hot dogs, boloney and red meat, that's associated with an increased risk of heart disease. And that's very, very consistent with what our colleagues in cancer are finding."
Anand even calls into question the weight loss successes attributed to red meat rich programs like the Atkins Diet, saying that simple calorie cutting is the true key to slimming down.
The McMaster researchers examined almost 200 previous papers that looked at heart and food relationships — good and bad — dating back to 1950. They then measured the heart effect conclusions of those studies based on four epidemiological criteria.
"If they met all four criteria we would classify the evidence as 'strong' for (say) vegetables and heart disease," Anand says.
"If they only met three of the criteria we called it moderate evidence." Meeting two or fewer of the criteria constituted weak evidence of a link, she says.
The criteria included the statistical strength of a study's association between food and heart disease and the consistency of that data across two or more studies.
It also looked at the amount of time researchers followed their subjects and the inclusion of information on diet and a host of heart disease risk factors like high cholesterol and blood pressure and hardening of the arteries.
Simon Fraser University nutrition expert Diane Finegood said the study provided "a very careful synthesis of the studies specifically linking coronary heart disease and dietary components and dietary patterns across populations."
Finegood, former head of Nutrition, Metabolism and Diabetes at the Canadian Institutes of Health Research, said the results, while not surprising, act as a valuable confirmation of what was already believed.
But she stressed that there may be differing associations between the foods and other chronic ailments like diabetes and cancer, and that even for heart disease, food risks and protections will differ between individuals.
"Wile this is a helpful analysis and provides helpful guidance it does not mean these results will determine an individuals experience," Finegood said in an emailed interview.
As for the study's take on red wine, Anand says there is evidence that drinking moderate amounts can confer moderate protection on the heart.
But she says alcohol is a dangerous, double-edged sword, with research showing even modest amounts it can increase cancer risks and that it can lead to excessive and destructive drinking.
"So as a physician, I never recommend a non-drinker to start drinking to prevent heart disease."
As for the Omega-3 products, Anand says those coming from fish seem to be heart protective, while those that come from plant sources like walnuts and flax seed have little in the research to support them.
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