Reducing Heart Attacks: Evidence that Nutrition and Lifestyle are Key

We often hear that eating a healthy diet and participating in healthy lifestyle activities lower the risk of heart disease. A recent study again proved this, but what was surprising was the extent to which these changes affect the incidence: an 80% reduction! So what exactly are these “heart healthy” lifestyle choices?

Cardiologists in Sweden recently studied approximately 20,000 healthy Swedish men ages 45-79 years, a group considered to be at significant risk for heart attacks. The study identified five practices that significantly decreased the incidence of heart attacks.

(1) a healthy diet (based on a Recommended Food Score which measured the amount of fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains, and fish that was consumed per month);
(2) moderate alcohol intake (defined as 10-30 g/day or 1-2 glasses of wine);
(3) abstinence from smoking;
(4) being physically active (walking/bicycling 40 min per day and exercising one hour per week); and
(5) having a waist circumference less than 95 cm (approximately 37 inches).

The study concluded that men meeting all 5 low-risk behaviors had 80% fewer heart attacks than those that did not practice any of the low-risk behaviors.

There are some limitations to this study. First, it studied only white men; however, there have been several other published studies showing similar benefits in other groups. Second, the study was mainly based on self-reporting of low- or high-risk behaviors and this can certainly limit the accuracy and validity of the results. Third, the study was conducted in Sweden, whose population is not representative of the United States. Fourth, though the study showed a decrease in heart attacks, the effect these lifestyle measures had on longevity was not reported. Lastly, the study falls short of being done in a randomized controlled fashion, which includes assigning people to different arms of the study and is considered the gold standard for evaluating scientific hypotheses.

Nevertheless, the study reinforces the cornerstones of preventing heart disease in large populations. So instead of relying only on drugs or medical devices to decrease heart disease, this study underscores that lifestyle choices are just as critical (if not moreso) in reducing heart attacks.

REFERENCES:

-Akesson, et. al.; Low- Risk Diet and Lifestyle Habits in Primary Prevention of Myocardial Infarction in Men, J Am Coll Cardiol. 2014;64(13):1299-1306. -Michels K.B., Wolk A.; A prospective study of variety of healthy foods and mortality in women. Int J Epidemiol. 2002;31:847-854.
-Akesson A., Weismayer C., Newby P.K., Wolk A.; Combined effect of low-risk dietary and lifestyle behaviors in primary prevention of myocardial infarction in women. Arch Intern Med. 2007;167:2122-2127.
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