Less nuts and vegetables, not cholesterol, puts the heart at real risk

An increased consumption of nuts can decrease the risk of cardiovascular diseases.

 |  3-minute read |   16-09-2018
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Science behind the preventive diet for heart has changed; cholesterol is no longer the culprit.

Let us understand that nearly 85 per cent of the cholesterol is synthesised within liver and the remaining 15 per cent comes from the food we eat. Even if we consume food, which is rich in cholesterol, our body takes care of it by reducing the production of cholesterol in the liver. So, one should not worry much about a high cholesterol diet.

vegetabe-690_091618113224.jpg Even if we consume food, which is rich in cholesterol, our body takes care of it by reducing the production of cholesterol in the liver. (Source: India Today)

Rather eating less fruits, less vegetables, less nuts, high salt and sugar, high trans fats are the actual problems in our diet which need correction.

Trans fats have been consistently shown to be associated with higher risk of coronary artery disease and sudden cardiac death. Trans fats raise LDL cholesterol (bad), triglycerides, lipoprotein A and lower HDL (good) cholesterol.

A recent Prospective Urban Rural Epidemiological (PURE) cohort study of 1,35,335 individuals in 18 countries with a median follow up of 7.4 years has suggested that high carbohydrate intake (more than 60 per cent) was associated with higher risk of total mortality (5). This study included a large number of patients from low-and-middle-income countries where individuals consumed refined carbohydrates such as white rice and white bread.

The role of total and saturated fats remains suspect and needs further studies especially in the light of the PURE study, which suggests that high intake of total and saturated fats may be cardioprotective. Sweets and carbohydrates increase triglyceride and decrease high-density cholesterol and increase small dense LDL which can further increase atherosclerosis (blockage), therefore it is suggested to consume low carbohydrate (40-60 per cent of energy).

This study confirms the heart healthy benefits of consuming fruits and vegetables rich in potassium. It has also shown that three-four servings per day are better than five servings per day, which is usually recommended.

nuts-690_091618113339.jpgFor primary and secondary prevention of cardiovascular diseases one should consume fresh fruits and vegetables, whole grains, legumes and nuts. (Source: India Today)

In fact, moderation is the key. Elements like sodium, potassium, chloride as in salt, fruits and vegetables should be consumed within a safe range as there is a U-shaped association between elements and cardiovascular disease. That means both low as well as excess intake of these is not healthy.

But for toxic elements such as in alcohol, tobacco, LDL there is a linear relationship which means that as the quantity of these toxins increase in our blood, the risk of cardiovascular diseases also increases.

An increased consumption of nuts has been seen to decrease the CAD risk. Several meta analyses have reported that nut consumption decreases fatal and non fatal cardiovascular disease.

In the PREDIMED trial, daily nut consumption coupled with a Mediterranean diet was reported to reduce CAD by 30 per cent, and stroke by 49 per cent. Nut consumption may also decrease the risk of Type 2 DM, hypertension and dyslipidemia.

Finally, for primary and secondary prevention of cardiovascular diseases one should consume fresh fruits and vegetables, whole grains, legumes and nuts. Sugar, salt and refined foods should be limited.

Trans fats should be avoided. Finally, to prevent cardiovascular diseases and mortality other lifestyle factors such as physical activity, avoidance of tobacco, stress control and control of obesity are needed in addition to a healthy diet. 

Also read: A wood-based fibre to replace fat in diet: Do we need it at all?

Writer

Dr JPS Sawhney Dr JPS Sawhney

Author is chairman, department of Cardiology, Sir Ganga Ram Hospital

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