Showing posts with label prevention. Show all posts
Showing posts with label prevention. Show all posts

Wednesday, April 27, 2016

Food to Restore a Heart

reproduced from Aurametrix

cereal fiber for survivors of heart attack
We know that diet, exercise and low-stress life will keep the heart healthy. But sometimes things happen that are beyond our control.

Thanks to more coordinated, faster emergency response and improved treatment, heart attacks aren't as deadly as they used to be. But survivors still face a substantial risk of further cardiovascular events.

How to restore after a heart attack and prevent another one? What to do besides obvious things such as taking medications, reducing stress, calories, avoiding urban air pollution and getting rid of bad lifestyle habits like smoking?

Increase Cereal Fiber

Dietary fiber helps to lower cholesterol levels (as it inhibits cholesterol synthesis, increases the production of short-chain fatty acid and the rate of bile excretion), blood pressure, glucose absorption, improving insulin sensitivity, and increasing levels of antioxidants. A high-fiber diet, in general, was associated with a 31% reduction in dying from any cause and a 35% reduction in death from heart disease among over 4 thousand heart attack survivors from the Health Professionals Study and the Nurses’ Health Study.

More recent Harvard study went a step further analyzing the types of fiber consumed by thousands of men and women who survived a first myocardial infarction (MI). All participants of the study increased their average dietary fiber intake after MI, and the greater the increase, the lower was the risk of subsequent all cause and cardiovascular mortality. among cereal fiber, fruit fiber, and vegetable fiber,  only intake of cereal fiber was strongly inversely associated with lower all cause and cardiovascular mortality: pooled hazard ratio 0.73 (0.58 to 0.91) for all cause mortality, 0.72 (0.52 to 0.99) for cardiovascular mortality. In the general population, a 20-40% risk reduction in coronary heart disease has consistently been observed among those who consume fiber-rich whole grains regularly

An earlier study of over 31,000 California Seventh-day Adventists found a 44% reduced risk of nonfatal coronary heart disease and an 11% reduced risk of fatal coronary heart disease for those who ate whole wheat bread compared with those who ate white bread.

One minor change in diet could, indeed, save a life.  

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Don't overdo it on the protein

Low carbohydrate plant diets might be beneficial in reducing blood pressure ​and reducing cholesterol.

Yet, Dr Shanshan Li and her Harvard colleagues did not find a health benefit for heart attack survivors from a low carbohydrate diet even if it was low in fat and came from plant sources.

Greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality post-MI.

According to the Institute of Medicine. healthy individuals should get at least 10% of their daily calories, but not more than 35%, from protein. Heart attack survivors in the Harvard and the Nurses’ Health Study ate from 15% to 20% protein (65 to 40% carbohydrates) and the lowest intake of protein seemed to be the best. It also correlated with the lowest intake of fat. Associations between the animal-based low carbohydrate diets and mortality were diminished after additionally adjusting for saturated fat.

A few older studies suggested that low carbohydrate plant-based diet may slightly decrease coronary heart disease in women and heart-healthy individuals, but there might be different dietary benefits in those survived from a heart attack.   

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Plant diets are definitely good for restoring the hearts. A study by Cleveland clinic  found that a plant-based diet in conjunction with cholesterol-reducing medication reversed heart disease in 70% of patients over a 12-year period. Vegetable oils high in linoleic acid (afflower oil, soybean oil, sunflower oil, and cottonseed oil.), though, failed to reduce heart disease and overall mortality and seemed to be actually worse for heart health than eating butter.
Nuts - eaten several times a week in small amounts - shown a consistent 30% to 50% lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease, as seen from several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study.

The Stanford Coronary Risk Intervention Project followed 300 people with coronary artery disease for four years and found the best predictor of new coronary blockages was dietary fat intake. As fat intake rose, the number of coronary blockages rose. Those patients with the lowest intake of dietary fat (about 10% to 15%) had the greatest amount of improvement and plaque shrinkage.

One day there could be probiotics for heart disease.

Research from Cleveland clinic proposes a new link between animal protein and coronary heart disease (CHD) that doesn’t involve cholesterol, but is mediated through "bad" for heart bacteria converting  trimethylamine to Trimethylamine N-oxide (TMAO) in the liver. The researchers followed roughly 4,000 adults for three years. At the end of the study period, those with the highest levels of TMAO had a 2.5-fold increased risk of heart attack, stroke and death.

Firmicutes Ruminococci are some of those bad bacteria, while Bacteroidales S24-7, an abundant family from Bacteroidetes, are inversely associated with TMA and TMAO levels.
And here is the last tip from Dr. Oz  - a sample diet he claims could reverse your heart disease in 28 days:
Breakfast
  • Oatmeal with dried cranberries
  • 4oz. of natural vegetable or fruit juice
Eating oatmeal is a great non-fat way to get your complex carbohydrates.
Morning Snack
  • Non-fat granola bar
  • Banana
  • One cup of tea; green tea, without milk or sugar, is ideal
Lunch
  • Stir-fried veggies with low-sodium teriyaki sauce and brown rice
  • Green salad with edamame, chickpeas, beans and fat-free raspberry dressing, and one whole wheat roll
A lunch like this provides plenty of protein, from non-animal sources.
Dinner
  • Tacos: black beans, brown rice, fat-free sour cream, fat-free cheese and salsa; corn tortillas
These tacos are low in fat and high in protein.
Night Snack
  • Hummus with assorted dipping vegetables


REFERENCES

Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. Journal of the American Heart Association, 3 (5) PMID: 25246449


Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, & Rimm EB (2014). Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ (Clinical research ed.), 348 PMID: 24782515

Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. Eur J Clin Nutr2006;60:1145-59.

Rimm EB, Ascherio A, Giovannucci E, Spiegelman D, Stampfer MJ, Willett WC. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA1996;275:447-51.


Halton TL, Willett WC, Liu S, Manson JE, Albert CM, Rexrode K, Hu FB. Lowcarbohydrate-
diet score and the risk of coronary heart disease in women.
N Engl J Med. 2006;355:1991–2002.

Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Lowcarbohydrate
diets and all-cause and cause-specific mortality: two cohort
studies. Ann Intern Med. 2010;153:289–298.

Gustenhoff P et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. Br Med J 1996;312:677-8.






Friday, December 17, 2010

Danger, Will Robinson!!! or injury prevention with sensors and algorithms


Health is determined by many factors including:
  • Behavior (Physical Activity, Eating habits, Tobacco or substance abuse, responsible sexual choices, etc)
  • Mental Health 
  • Injury and Violence 
  • Environmental Quality 
  • Preventative measures such as immunization 
  • Access to Health Care

All these factors are quantifiable, predictable and preventable. Injuries are most likely to be  perceived as “accidents” and “acts of fate”,  but they depend on the same determinants as other health factors: individual behavior, social and physical environment.  The likelihood of injuries -  unintentional ones and those caused by acts of violence - can be computed from physical location (estimations for USA1 are a good example), gene-environment interactions2, prior medical history, and physical traits3.

There are many ways to prevent injuries - just say "no" to risky behaviors, wear preventative gear while playing sports or fall-optimized shoes for elderly, watch out for others engaged in similar activities... Yet, sometimes we forget to watch, don't have access to histories of others or get diverted.  Would a body sensor or a gadget with smart software be able to warn us about potential accidents ahead to help prevent accidents?  What would it need to measure?

Software and devices automatically detecting and reporting accidents already exist:

Halo Monitoring's fall detection system, for example,  consists of a chest strap and belt clip with motionOnStar or mbrace that "intelligently integrate the driver, the vehicle and the environment" - capabilities such as this will be provided in the area of next-generation health management systems like Aurametrix.
sensors, heart rate and skin temperature monitors. Although the system detects falls only after they happen, a study showed that just the fact of wearing it increases alertness of seniors and reduces the number of falls. Although fall detection systems are not as advanced as telematics for cars - like
Unprecedented accumulation of data  - such as snapshots of driving behavior or 1.2 million person-years of hip fracture observations (Kanis JA) allows development of smarter software able to predict injuries.  Logistic regression models (Kononen et al., 2011) predict seriousness of auto accidents,  first-principles mathematical models (such as AHAAH for the ear) connect forces with injuries, neural net and other data mining approaches foretell which juvenile offenders are likely to return to crime (source of  "intentional injuries"), or allow to calculate risk of fractures based on milk intake, personal history of accidents and body mass index. Self-quantifiers such as RenĂ© Ghosh are able to figure out how to use their own data to predict future injuries. Using simple math (Riegel equation bringing all running logs on to a comparable level) and trend analysis, he tied his accidents to wanes following waxes in running performance. Researchers keep refining the variables predicting injuries.  Swanenburg et al., for example, predicted multiple falls for those with a history of multiple falls (odds ratio, 5.6) and use of multiple medications (odds ratio, 2.3). And there is another simple measurement of standing position helpful in prediction. Frequent fallers, indeed, have a narrower stance width than non-fallers.


In the always-connected smart-sensor-equipped future, things such as Intel's magic carpet - picking up the weight, angle and pressure of steps - will be a commodity. Gene tests predicting injuries will be integrated with data coming from our carpets, clothing, footwear and location information. And this may be sooner than you think.


References

1. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS); 2010 Mar 4 Available from: http://www.cdc.gov/injury/wisqars/index.html

2. Husted JA, Ahmed R, Chow EW, Brzustowicz LM, Bassett AS. Childhood trauma and genetic factors in familial schizophrenia associated with the NOS1AP gene. Schizophr Res. 2010 Aug;121(1-3):187-92. PMID: 20541371

3. Swanenburg J, de Bruin ED, Uebelhart D, & Mulder T (2010). Falls prediction in elderly people: a 1-year prospective study. Gait & posture, 31 (3), 317-21 PMID: 20047833

4. Kononen DW, Flannagan CA, Wang SC. Identification and validation of a logistic regression model for predicting serious injuries associated with motor vehicle crashes. Accid Anal Prev. 2011 Jan;43(1):112-22. PMID: 2109430

5. Price GR. Predicting mechanical damage to the organ of Corti. Hear Res. 2007 Apr;226(1-2):5-13. Epub 2006 Sep 15.PMID: 16978813


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