People who survive heart attacks have a greater chance of living longer if they increase their dietary intake of fibre – with cereal fibres especially beneficial, research from the Harvard School of Public Health has found.
The research, which was published in the online journal BMJ on 29 April 2014, found that those who ate the most fibre had a 25 per cent lower chance of dying in the nine years after their heart attack compared with those who ate the least fibre. Every 10g per day increase in fibre intake was associated with a 15 per cent reduced risk of dying over the nine-year follow-up period.
When the researchers looked at the three different fibre types – cereal, fruit and vegetable – only higher cereal fibre intake was strongly associated with an increased chance of long-term survival after a heart attack. Breakfast cereal was the main source of dietary fibre.
The researchers said that with more people surviving heart attacks, it would be increasingly important to find out what lifestyle steps people can take alongside their medication to improve long-term health prospects.
It is well-known that high dietary fibre intake reduces the risk of developing coronary heart disease in healthy individuals. However, until now it was unclear whether increased fibre intake would help heart attack survivors live longer.
The research team analysed data from two big US studies, the Nurses’ Health Study of 121,700 female nurses and the Health Professional Follow-up Study of 51,529 male health professionals. In both studies, the participants completed detailed questionnaires on their lifestyle habits every two years.
The researchers looked at the 2,258 women and 1,840 men who survived a first myocardial infarction (MI) – a heart attack – during the course of the studies. They were followed for an average of almost nine years after their heart attack, during which time 682 of the women and 451 of the men died.
Participants were divided into five groups (quintiles) according to how much fibre they ate after their heart attack. When considering only cardiovascular causes of death (heart attack, stroke and coronary heart disease), the top quintile had a 13 per cent lower mortality risk compared with the bottom quintile.
All the results were adjusted for other factors that might affect the chance of survival after a heart attack, including age, medical history and other dietary and lifestyle habits.
The researchers said that heart attack survivors have a higher risk of dying than the general population and were often more motivated to make changes to their lifestyle. However treatment to improve their chances of living longer generally neglects the importance of a healthier lifestyle in favour of long-term medication.
How fibre helps
High dietary fibre intake can improve blood lipid levels and reduce the risk of high blood pressure, obesity and diabetes while a low-fibre diet is associated with an increased risk of colorectal cancer.
Researchers said less than 5 per cent of Americans consumed the minimum recommended fibre intake of 25g per day for women and 38g per day for men. In the UK, adults are recommended to eat at least 18g of fibre daily but dietary surveys suggest people eat an average of only 14g. US experts recommend up to 38g a day.
Fruit, such as bananas and apples, root vegetables, such as carrots and potatoes, wholemeal bread, cereals and bran are all good sources of dietary fibre. A jacket potato and baked beans contain about 10g of fibre
Bowl of bran – 10g
Jacket potato – 5g
2 slices of wholemeal bread – 4.2g
Six dried apricots – 4g
Bowl of muesli – 3.5g
One orange or pear – 3g fibre
Last night, 28th April 2014, London’s Guildhall played host to the elite of the gastronomic world with a glittering ceremony to announce and celebrate The World’s 50 Best Restaurants 2014, sponsored by S.Pellegrino & Acqua Panna. The list is considered by some as one of the highlights of the global gastronomic calendar, and has emerged as an upstart rival to the Michelin rankings.
Danish restaurant Noma has regained its crown as the world’s best restaurant. The two Michelin star restaurant in Copenhagen was toppled in last year’s awards after three consecutive years by El Celler de Can Roca, a Spanish family restaurant, but has now had its title restored.
1. Noma, Copenhagen, Denmark
2. El Celler de Can Roca, Girona, Spain
3. Osteria Francescana, Modena, Italy
4. Eleven Madison Park, New York, USA
5. Dinner by Heston Blumenthal, London, UK
6. Mugaritz, San Sebastián, Spain
7. D.O.M, Sao Paulo, Brazil
8. Arzak, San Sebastian, Spain
9. Alinea, Chicago, USA
10. The Ledbury, London, UK
11. Mirazur, Menton, France
12. Vendome, Bergisch Gladbach, Germany
13. Nahm, Bangkok, Thailand
14. Narisawa, Tokyo, Japan
15. Central, Lima, Peru
16. Steirereck, Vienna, Austria
17. Gaggan, Bangkok, Thailand
18. Astrid y Gastón, Lima, Peru
19. Fäviken Järpen, Sweden
20. Pujol, Mexico City, Mexico
21. Le Bernardin, New York, USA
22. Vila Joya, Albufeira, Portugal
23. Restaurant Frantzén, Stockholm, Sweden
24. Amber, Hong Kong, China
25. L’Arpège, Paris, France
26. Azuermendi, Larrabetzu, Spain
27. Le Chateaubriand, Paris, France
28. Aqua, Wolfsburg, Germany
29. De Libreije, Zwolle, Netherlands
30. Per Se, New York, USA
31. L’Atelier Saint-Germain de Joël Robuchon, Paris, France
32. Attica, Melbourne, Australia
33. Nihonryori RyuGin, Tokyo, Japan
34. Asador Etxebarri, Atxondo, Spain
35. Martin Beragategui, San Sebastian, Spain
36. Mani, Sao Paolo, Brazil
37. Restaurant Andrew, Singapore
38. L’Astrance, Paris, France
39. Piazza Duomo, Alba, Italy
40. Daniel, New York, USA
41. Quique Dacosta, Denia, Spain
42. Geranium, Copenhagen, Denmark
43. Schloss Schauenstein, Furstenau, Switzerland
44. The French Laundry, Yountville, USA
45. Hof Van Cleve, Kruishoutem, Belgium
46. Le Calandre, Rubano, Italy
47. The Fat Duck, Bray, UK
48. The Test Kitchen, Cape Town, South Africa
49. Coi, San Francisco, USA
50. Waku Ghin, Singapore
- Speciality Nutritionals – Consumers who once relied on nutritional supplements are switching to fortified and functional foods.
- Get Real – six out of ten consumers look for ingredients they can recognise while shopping for food and seek out foods made with simple, real and natural ingredients.
- Hispanic Health – America’s 52m Hispanics spent an estimated $6.9bn on functional foods in 2012 and $9.4bn on natural/organic foods/drinks.
- The Protein Evolution – The protein market is still centre stage with 57% of consumers, particularly between the ages of 18-34 and above age 65, seeking protein sources.
- Kid-Specific – Nearly half of America’s 32m mums who say they always buy health foods/drinks for their children are looking for a wider range of healthy, convenient, kid-friendly foods/drinks with nutrient and calorie levels specific to youngsters
- Pharma Foods – Eight out of ten consumers believe that functional foods can help or prevent the onset of heart disease, hypertension, osteoporosis and type 2 diabetes.
- Alternatives – 80% of households now eat meatless meals for dinner on occasion and eggs are the most popular alternative followed by beans, lentils or legumes.
- Performance Nutrition – Nearly six out of ten adults used a sports nutrition product in 2012 and the combined consumer sales of sports nutrition supplements, nutrition bars and energy drinks topped $24bn in 2012, up by 11.2%
- Weighing in – Weight conscious consumers have ditched deprivation-style weight loss campaigns in preference for healthy eating, while adding specific real food, components and nutrients to their diets.
- Gen Zen – Today’s millennials, aged between 14 and 33, view their food choices as healthier, more expensive, more natural and or organic, less processed, better tasting and fresh.
Teaching people how to flavour food with spices and herbs was “considerably more effective” at lowering salt intake than having them reduce their salt intake on their own, according to research from the University of California.
The study, which was presented in March 2014 at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism Scientific Sessions 2014, used a group of 55 volunteers and was completed in two stages. More than 60 per cent of the participants in the study had high blood pressure, 18 per cent had diabetes and they were overweight.
In the first phase of the study, the 55 volunteers ate a low-sodium diet for four weeks. Researchers provided all foods and calorie-containing drinks.
In the second phase, half of the study volunteers participated in a 20-week intervention aimed at reducing their sodium intake to 1,500 mg/day by using herbs and spices. The other half reduced sodium on their own.
Those assigned to the behavioural intervention group had cooking demonstrations and had a chance to share how they were changing traditional recipes to remove salt and include spices. The researchers did not emphasise specific spices, and encourage participants to try different things to find out what they liked most.
Learning how to use herbs and spices helped
The researchers found that in first phase of the study, sodium intake decreased from an average 3,450 mg/day to an average of 1,656 mg/day. In the second phase, sodium intake increased in both groups.
However, those who received the behavioural intervention consumed an average of 966 mg/day of sodium less than the group that did not received the intervention.
“People in the intervention group learned problem-solving strategies, use of herbs and spices in recipes, how culture influences spice choices, how to monitor diet, overcoming the barriers to making dietary changes, how to choose and order foods when eating out, and how to make low-sodium intake permanent,” said Cheryl A.M. Anderson, PhD, MPH, lead author of the study and Associate Professor in the Department of Family and Preventative Medicine at the University of California San Diego.
“Salt is abundant in the food supply and the average sodium level for Americans is very high — much higher than what is recommended for healthy living,” Dr Anderson said. “We studied the use of a behavioural intervention where people learn how to use spices and herbs and less salt in their daily lives,” she said.
“Given the challenges of lowering salt in the American diet, we need a public health approach aimed at making it possible for consumers to adhere to an eating pattern with less salt,” Dr Anderson said. “This intervention using education and tasty alternatives to sodium could be one solution,” she said.
Eating seven or more portions of fruit and vegetables a day is healthier than the minimum five currently recommended and would prolong lives, experts say. A study of 65,226 men and women indicated the more fruit and vegetables people ate, the less likely they were to die – at any given age. Seven a day cut the risk of dying from cancer and heart disease. But the government says its “five-a-day” advice is sufficient and that many of us struggle to achieve even this.
Experts said other lifestyle factors, such as not smoking or drinking excessively, may have accounted for the drop in mortality, not just fruit and veg consumption, although the study authors said they had tried to account for this. The University College London researchers used the National Health Survey, which collects data from people in England each year through questionnaires and nurse visits, to look at diet and lifestyle. They analysed data between 2001 and 2008, which provided a snapshot rather than people’s continuing dietary habits. The study looked at general mortality as well as death from cancer, heart disease and stroke, and found risk of premature death from any cause decreased as fruit and veg consumption increased. Risk of death by any cause over the course of the study was reduced by 42% for seven or more (up to around 10 portions a day)
Fresh vegetables had the strongest protective effect, followed by salad and then fruit. Fruit juice conferred no benefit, while canned fruit appeared to increase the risk of death – possibly because it is stored in sugary syrup, say the researchers. Fruit and vegetables could have a protective effect against disease as they contained antioxidants, which repair damage to cells.
A “portion” meant about 80g (3oz), meaning “one large fruit or a handful of smaller fruit or veg”. But some experts said the work was not conclusive and that other lifestyle factors may have influenced the results.
In Australia, the government’s advice is “two plus five” a day – encouraging people to eat two helpings of fruit and five portions of vegetables.