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The risk of ischemic heart disease with low-fat, high-carbohydrate diets
by: Michal R. Pijak
There is convincing scientific evidence that type of fat have a more important role in determining the risk of coronary heart disease(CHD) than total amount of fat in the diet.(1) However, because of misleading presentation of epidemiological data by some authors(1), the readers might be left with the impression that low-fat, high- carbohydrate diet is the best option for patients with CHD risk.
In fact, high- carbohydrate diets, in the absence of weight loss, can lead to both elevated triglyceride and reduced HDL cholesterol, effects that may be associated with increased risk for CHD.(2) Although these effects may be lessened with dietary fiber and moderate physical activity, they appear to be worse among individuals with insulin resistance.(3)
As reviewed by Kris-Etherton(4) adverse metabolic effects of low fat diet do not occur with substitution of monounsaturated (MUFA) or polyunsaturated (PUFA) fatty acids for saturated and trans-fatty acids. This is also the case for individuals with diabetes, with the added benefit of better glycaemic control.(5)
As predicted by metabolic studies, replacement of saturated fat, and even more so trans fatty acids with either PUFA or MUFA was associated with a larger reduction in risk of CHD than simple reduction of total fat consumption.(6) With respect to weight control, a moderate-fat diet can be as, or even more, effective that lower-fat diet. (6)
References
1. Hu FB, Manson JE, Willet WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr 2001;20:5-19.
2. Fung MA, Frohlich JJ. Common problems in the management of hypertriglyceridemia. CMAJ 2002;167:1261-6.
3. Jeppesen J, Schaaf P, Jones G, Zhou MY, Chen YD, Reaven GM. Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. Am J Clin Nutr 1997;65:1027-33.
4. Kris-Etherton PM, Kris-Etherton PM, Binkoski AE, Zhao G, Coval SM, Clemmer KF, et al. Dietary fat: assessing the evidence in support of a moderate-fat diet; the benchmark based on lipoprotein metabolism. Proc Nutr Soc 2002;61:287-98.
5. Rivellese AA, De Natale C, Lilli S. Type of dietary fat and insulin resistance. Ann N Y Acad Sci 2002;967:329-35.
6. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ et al. AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation. 2000;102:2284-99.



About the author:
Dr. Michal R. Pijak is a consultant in rheumatology, allergy and clinical immunology at the University Hospital in Bratislava, Slovakia


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 Prevent Heart Disease
 by: Mike Spencer

You should always keep in mind that whatever actions you do today can either help to prevent, delay or minimize the effect of heart disease or worsen it. The key is to control risk factors. Granted that you cannot control every risk factor for heart disease such as family history but you can definitely do something about your behavior. Age and gender also influence your risk of heart disease.

Major Risk Factors of Heart Disease

Cholesterol Levels

Cholesterol is a type of a lipid, a soft, fatlike substance that serves as a source of fuel. Excessive cholesterol can cause buildup of atherosclerotic plaque. Accumulation of plaque in arteries can block blood flow and lead to a heart attack. LDL cholesterol, the so-called "bad" cholesterol, is transported to sites throughout the body, where it's used to repair cell membranes or to make hormones. LDL cholesterol can accumulate in the walls of your arteries. HDL cholesterol, the so-called "good" cholesterol, transports cholesterol to the liver, where it's altered and removed from the body.

Blood Pressure

Normal blood pressure level is defined as less than 130 millimeters of mercury (mm Hg) for systolic blood pressure and less than 85 mm Hg for diastolic blood pressure. The higher the blood pressure, the more likely it is to take a toll on the heart and on the brain. Blood pressure should be checked whether or not your levels are high. For normal, check once every two years. For high-normal, check once a year. If extremely high, you should get immediate care. Then get multiple measurements to know if a high level is sustained over time.

Diabetes

Another risk factor for heart disease is diabetes, a chronic disease of insulin deficiency or resistance. Type 2 diabetes, the most common type, is associated with obesity and may be prevented by maintaining ideal body weight through exercise and balanced nutrition.

Tips For Controlling Risk of Heart Disease

Stop Smoking

The effect of smoking on your lungs can cause almost every other medical condition.

Get Active

Routine physical activity is highly recommended and helpful in controlling obesity. Try to perform 30 minutes of moderate physical activity every day. Fast walking is one of the best way to prevent heart disease. If you can lose even a small amount of weight, five pounds for example, it may have a positive effect on lipid levels and blood pressure preventing heart disease.

Limit Alcohol Consumption

Limit daily alcohol intake to three ounces or fewer to prevent heart disease. People who drink large amounts of alcohol (six to eight ounces a day) tend to have higher blood pressure.

Watch What You Eat

Eat five helpings of fruits and vegetables daily to prevent heart disease.

Maintain adequate dietary potassium, calcium and magnesium intake.

Reduce saturated fats and cholesterol to stay away from heart disease.

Copyright 2005 Mike Spencer


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