Heart Health and Diet from the Past to the Present: What’s changed?

Cardiovascular diseases are the leading cause of mortality both in the world and in our country. According to Turkish Statistics Institute-2016, 4 out of 10 adults die in Turkey because of cardiovascular diseases.

Factors such as elderly age, male gender and family history are the main risk factors for cardiovascular diseases. High blood pressure, lipid and cholesterol levels, and increased body weight are other important factors that can be modified through the diet and life style.

Researches on cardiovascular diseases and diet have carried with some diet trends from past to present. Individuals tend to make various changes in their diet patterns based on these trends. So, which nutrients has effected from diet trends? How do these changes affect the adequate and balanced diet?



Limitation of fat intake

Limitation of dietary fat is still subject to debates. It is reported that strict limitation of dietary fat intake may change the energy balance and have adverse effects on adequate and balanced diet by causing a reduction in sense of fullness and increase in the constipation and carbohydrate intake. In addition to the disturbance in energy balance, insufficient intake of certain essential fatty acids may occur. Moreover, it has been shown that a diet restricting the animal based food such as meat, egg, milk and dairy products is not a fundamental deterministic factor that affects the cholesterol levels in blood.

Which dietary fats and how much should we consume?

Fats are fundamental elements of an adequate and balanced diet and fats should contribute 25-35% of total daily energy intake. This ratio, corresponds to an average 50g fat intake for a healthy adult. Variety must be ensured for dietary fats in order to achieve a balanced fatty acid pattern in the diet. Heart health may be supported through adequate consumption of vegetable oil such as olive oil, hazelnut oil, sunflower oil, corn oil and oily seeds such as walnut, almond, hazelnut, and consumption of fish two times a week as fatty fish are rich sources of omega 3 fatty acids. Consumption frequency and amount of animal fats as butter and saturated fats such as margarine should be watch.

Limitation of carbohydrates

Limitation of fat intake may lead to disturbance of the energy balance and increase in carbohydrate intake while limitation of carbohydrates may lead to increased fat intake. Therefore, providing 55-65% of the daily energy intake from carbohydrates is important for keeping the fat intake within acceptable limits. The recommended daily carbohydrate intake for a healthy individual is 300-400 g on average. However, the type of carbohydrates is as important as the consumed quantity.

Which carbohydrates and how much should we consume?

Carbohydrates are classified in two groups as simple and complex. N0n-refined, i.e., whole cereal grains such as wheat, barley, rye and oat, wholemeal breads, pasta, bulgur and vegetables can be classified as complex carbohydrate sources. Fructose in fruits and sucrose can be shown as examples of simple carbohydrates. Shifting the intake towards complex carbohydrates can help regulate the blood glucose levels and thus may help reduce the risk of cardiovascular diseases that may be increased by long-term high glucose levels in blood. Whole grains can support heart health through fibre intake and regulation of blood glucose levels.

Gluten-free diet

Recently, diets restricting the intake of gluten which is present in wheat and some cereals are popular. For healthy individuals it is not a need or a must to restrict the gluten containing carbohydrates who do not suffer from gluten intolerance or celiac disease. Gluten-free diet may change the energy balance, leading increased fat and salt intake and inadequate intake of fibres and vitamin B. Increased fat and salt intake but restricted fibre intake and vitamin B may have an adverse effect on the heart health in the long-term.

Limitation of salt

It has been proven that excessive salt intake is associated with cardiovascular diseases such as hypertension, heart attack and stroke. World Health Organization recommends to limit salt intake below 5g/day. Limiting salt consumption in 5 grams/day has been reported to reduce the risk of stroke by 23% and the risk of cardiovascular diseases by 17%.

In conclusion;

Adequate and balanced diet and active lifestyle are essential for maintaining health. It is top priority to have an adequate and balanced diet and to live an active lifestyle to reduce the heart disease risk. Replace refined grains with whole grains and eating fish 2 times a week, and consuming fruits and vegetables every day, limiting salt intake and fried food, and keep fat intake in recommendations and exercising 150 minutes in total and at least 3 times a week may help reduce heart disease risk. This pattern suggests the Mediterranean diet and it is the only type of diet with proven contribution to health.

References
1. WHO, Cardiovascular diseases (CVDs) Fact Sheet, 2017, http://www.who.int/mediacentre/factsheets/fs317/en /
2. Turkish Statistics Institute, Statistics on Causes of Death, 2016 http://www.tuik.gov.tr/PreHaberBultenleri.do?id=24572 (November, 2017).
3. Harvard Health Publications, Harvard Medical School, Food trends through the years: A mixed bag for heart health?, https://www.health.harvard.edu/blog/food-trends-through-the-years-a-mixed-bag-for-heart-health 2017090612317?utm_source=delivra&utm_medium=email&utm_campaign=BF20170911-DOH&utm_id=625521&dlv-ga-memberid=25989734&mid=25989734&ml=625521 (November, 2017)
4. Eat Right. Academy of Nutrition and Dietetics, Heart Health and Diet, http://www.eatright.org/resource/health/wellness/heart-and-cardiovascular-health/heart-health-and-diet (November, 2017).
5. American Heart Association, Low gluten diets may be associated with higher risk of type 2 diabetes, http://newsroom.heart.org/news/low-gluten-diets-may-be-associated-with-higher-risk-of-type-2-diabetes?preview=43ac (November, 2017).
6. World Health Organization, WHO issues new guidance on dietary salt and potassium, http://www.who.int/mediacentre/news/notes/2013/salt_potassium_20130131/en/ (November, 2017).
7. World Health Organization, Global recommendations on physical activity for health, http://www.who.int/dietphysicalactivity/factsheet_adults/en/ (November, 2017).
8. Harvard Health Publications. Adopt a Mediterranean diet now for better health later, 2013. https://www.health.harvard.edu/blog/adopt-a-mediterranean-diet-now-for-better-health-later-201311066846




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