Less of This, More of That: Diet and Heart Failure

There are several major risk factors for heart failure, and all of them are related to diet: coronary artery disease, high blood pressure, insulin resistance or diabetes, and obesity. Lots of studies look at what we call micronutrients, such as specific vitamins or fiber or types of fats, but fewer seem to focus on more practical food choices. Regular or low-fat dairy? Eggs or no eggs? Worse, many studies have been limited to whites or to men or both.

A recent study known as the ARIC study included over 14,000 African-American and white men and women between the ages of 45 and 64 (J Am Diet Assoc 2008;108(11):1881-1887). At the beginning of the study, in 1987, the participants completed a food questionnaire that asked how often they ate specific foods or beverages. There were nine levels of frequency to choose from, ranging from “never or less than one time per month” to “six or more times per day.” Questions included what type of breakfast cereal they ate (if any) and whether they used salt in cooking or added salt to their food at the table.

Some of the specific food groups that were evaluated included:

• Whole grains (oatmeal/grits, whole-grain cold cereal, breads)
• Eggs (boiled, poached, fried, scrambled, etc.)
• Fruits and vegetables (fruits, fruit juices, tomatoes, potatoes, legumes, green leafy, etc.)
• Fish (dark meat fish, tuna, other fish, other seafood)
• Nuts (nuts or nut butters)
• High-fat dairy (whole milk, cheese, cream)
• Red meat (hamburger, meat in sandwiches or other mixed dishes, hot dogs, sausage or salami, bacon, etc.)

The participants completed follow-up exams every three years for an average of 13 years or until they were hospitalized for heart failure or died. The diets of those who had heart failure were then compared with those who did not.

Generally speaking, those who developed heart failure tended to be older, more often African-American, less often female, and tended to be less well educated, less physically active, and more often tended to be current smokers than drinkers. Generally those who developed heart failure had a higher Body Mass Index (BMI) and Waist to Hip ratio. Their diets tended to include more refined grains (as opposed to whole grains), more high-fat dairy products, and more red and processed meat than those who did not develop heart failure.

What this means for you

This study adds weight to our current knowledge about diet and heart disease, showing that there seems to be little difference between races and genders when it comes to what type of diet helps prevent heart failure: whole grains, minimal and low-fat dairy, less red meats and less processed meat.

First posted: March 4, 2009