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Cardiovascular disease (CVD) remains the leading cause of death in the United States, claiming more than 800,000 lives
each year.
A healthy diet is a key lifestyle strategy to reduce cardiovascular disease risk factors, including high blood pressure and cholesterol levels, and ultimately prevent atherosclerotic heart disease — or hardening and narrowing of the arteries caused by fat accumulation that can lead to heart attacks and strokes
.
However, there is little data to guide patients in deciding which heart-healthy diet
to adopt.
In a new study, researchers at Beth Israel Women's Medical Center (BIDMC) compared the impact of three dietary patterns on patients' risk of experiencing cardiovascular events over the next decade — the Dietary Method for Controlling High Blood Pressure (DASH) diet, a diet rich in fruits and vegetables, and a typical Western diet
low in fruits and vegetables and high in fat and sodium 。 The team's findings suggest that although the DASH diet and the fruit/vegetable diet each reduced risk scores by about 10 percent over an eight-week period, the DASH diet confered additional benefits
for women and black adults compared to the Western diet.
The findings were published in the American Journal of Cardiology
.
"While physicians and patients rely on widely available data when choosing appropriate pharmacotherapy to prevent atherosclerotic cardiovascular disease, there is limited anticipatory evidence for risk reduction through established lifestyle interventions," said
Stephen P.
Jurashcek, Ph.
D.
, a clinical investigator and corresponding author at the Department of Medicine at BIDMC.
"Our research suggests that the benefits associated with these diets may vary
by gender and ethnicity.
While diets rich in fruits and vegetables reduced risk for both female and black participants, the DASH diet affected women and adult black people twice and four times
as much.
”
To determine the effect of different diets on an individual's risk of developing atherosclerotic cardiovascular disease, Juraschek and his colleagues collected data on 459 adults between the ages of 22 and 75 who participated in the original DASH trial
between 1994 and 1996.
The participants, who were about half female and half black, were randomly assigned to one of three diets for 8 weeks
.
The control group had a diet higher
in total fat, saturated fat, and cholesterol.
The fruit and vegetable diet provided more produce, but was otherwise not significantly different
from the control diet.
The DASH diet also provides more fruits and vegetables, but emphasizes more whole grains, lean proteins, nuts, and low-fat dairy products while reducing fat, saturated fat, cholesterol, and sugar
.
The DASH trial, first published in 1997, showed that the DASH diet not only lowered systolic blood pressure in adults with blood pressure and high blood pressure, but also lowered HDL cholesterol levels
compared to a control diet.
A diet high in fruits and vegetables has been shown to lower systolic blood pressure to a lesser extent, but also raise HDL cholesterol levels
.
When Juraschek and his colleagues compared the data, they found that both the DASH diet and the fruit and vegetable diet reduced participants' overall risk of developing atherosclerotic cardiovascular disease by about 10 percent
at 10 years.
However, this effect is not demographically consistent
.
The DASH diet reduced women's 10-year risk scores by nearly 13 percent, compared to just over 6 percent
for men.
In addition, DASH reduced 10-year risk scores by nearly 14 percent in black adults and only 3 percent
in non-black adults.
"These findings could have significant implications for both clinical practitioners and policymakers," said first author Sun Young Jeong, MD, Master of Public Health, and an internal medicine resident at
BIDMC.
"Cardiovascular disease is the leading cause of death in women, and high blood pressure is also more strongly linked to heart failure and death in women than in men
.
We also know that women are less likely to receive risk factor modification therapies such as statins, so we found that DASH may be more effective in women, which is related to
lifestyle counselling in this group.
”
"Similarly, disparities in access to healthy foods have been a major focus of policy efforts to promote greater intake of fruits and vegetables by black adults," said
Juraschek, an assistant professor of medicine at Harvard Medical School.
"Our study suggests that the DASH diet pattern may provide more preventive benefits
to black adults than by emphasizing only fruits and vegetables.
" This is especially important because dietary patterns have been identified as one of the most important mediators of
hypertension risk in black adults.
”