'Western' diet increases heart attack risk globally

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Public release date: 20-Oct-2008

http://www.eurekalert.org/pub_releases/2008-10/aha-di101708.php

Contact: Bridgette McNeill

American Heart Association

'Western' diet increases heart attack risk globally

American Heart Association rapid access journal report

The typical Western diet — fried foods, salty snacks and meat — accounts

for about 30 percent of heart attack risk across the world, according to

a study of dietary patterns in 52 countries reported in Circulation:

Journal of the American Heart Association.

Researchers identified three dietary patterns in the world:

* Oriental: higher intake of tofu, soy and other sauces;

* Prudent: higher intake of fruits and vegetables; and

* Western: higher intake of fried foods, salty snacks, eggs and meat.

The Prudent diet was associated with a lower heart attack risk than the

Oriental, researchers said.

" The objective of this study was to understand the modifiable risk

factors of heart attacks at a global level, " said Salim Yusuf, D.Phil.,

the study's senior author.

Previous studies have reached similar conclusions about the Prudent and

Western diet in the United States and Europe. This study broadens those

findings and identifies a unique dietary pattern that researchers

labeled " Oriental " (because of a higher content of food items typical of

an Oriental diet.) The dietary pattern recommended by the American Heart

Association is similar to the Prudent diet described in this study.

" This study indicates that the same relationships that are observed in

Western countries exist in different regions of the world, " said Yusuf,

professor of medicine at McMaster University and director of the

Population Health Research Institute at Hamilton Health Sciences in

Ontario, Canada.

Researchers analyzed the INTERHEART study, which documents the

association of various risk factors and the risk of heart attack in

about 16,000 participants in 52 countries. Here, they analyzed 5,761

heart attack cases and compared them to 10,646 people without known

heart disease (controls).

The researchers created a dietary risk score questionnaire for heart

attacks patients, based on 19 food groups and adjusted it for dietary

preferences for each country. Trained medical personnel interviewed the

heart attack patients and the control group. The questionnaires included

healthy food items (such as fruits and vegetables) and unhealthy food

items (such as fried foods and salty snacks).

" A simple dietary score, which included both good and bad foods with the

higher score indicating a worse diet, showed that 30 percent of the risk

of heart disease in a population could be related to poor diet, " said

Romania Iqbal, Ph.D., lead author of the study.

After adjusting for known risk factors, researchers found:

* People who consumed the Prudent diet of more fruits and

vegetables had a 30 percent lower risk of heart attack compared to

people who ate little or no fruits and vegetables.

* People who consumed the Western diet had a 35 percent greater

risk of having a heart attack compared to people who consumed little or

no fried foods and meat.

* The Oriental pattern showed no relationship with heart attack risk.

Researchers said that while some components of the Oriental pattern may

be protective, others such as the higher sodium content of soy sauces,

may increase cardiovascular risk, neutralizing any relationship.

It's expensive and time-consuming to establish a large and long-term

study examining the relationship of diet and heart attack in every

region of the world. So the approach of this study is the only feasible

way to examine the relationship to diet and heart disease from multiple

populations in a relatively short time at an affordable cost, Yusuf said.

Data from this study helped confirm that changes in dietary intake,

including the consumption of more fruits and vegetables, can help reduce

the risk of having a heart attack in populations worldwide, he said.

" At the same time, an unhealthy dietary intake, assessed by a simple

dietary risk score, accounts for nearly one-third of the world

population's attributable risk, " Yusuf said.

###

Other co-authors are: Anand, M.D.; Ounpuu, Ph.D.;

Shofiqul Islam, M.Sc.; Xiaohe Zhang, M.Sc.; Sumathy Rangarajan, M.Sc.;

Jephat Chifamba, MD.; Ali Al-Hinai, M.D.; and Matyas Keltai. Individual

author disclosures can be found on the manuscript.

The INTERHEART study was funded by the Canadian Institutes of Health

Research; the Heart and Stroke Foundation of Ontario; the International

Clinical Epidemiology Network; and through unrestricted grants from

several pharmaceutical companies (with major contributions from Astra

Zeneca, Novartis, Hoechst n Roussel [now Aventis], Knoll

Pharmaceuticals [now Abbott], Bristol-Myers Squibb and

Sanofi-Sythelabo); and by various national bodies and pharmaceutical

firms in different countries. In the United States, King Pharma provided

funding. A complete list of funding agencies are in the manuscript.

Statements and conclusions of study authors published in American Heart

Association scientific journals are solely those of the study authors

and do not necessarily reflect the association's policy or position. The

association makes no representation or guarantee as to their accuracy or

reliability. The association receives funding primarily from

individuals; foundations and corporations (including pharmaceutical,

device manufacturers and other companies) also make donations and fund

specific association programs and events. The association has strict

policies to prevent these relationships from influencing the science

content. Revenues from pharmaceutical and device corporations are

available at www.americanheart.org/corporatefunding.

--

ne Holden, MS, RD

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