Tag Archives: american heart association

Salt Report From IOM Sparks Much Heat, Only A Little Light Reply

by • People, Places & Events, Policy & Ethics, Prevention, Epidemiology & Outcomes • Tags: , , , ,

An Institute of Medicine report on salt earlier this week sparked a lot of controversy. The report concludes that there’s no evidence to support current efforts to lower salt consumption to less than 2,300 mg/day. Unfortunately, the press coverage offered little insight into the science behind the issue. On the Knight Science Journalism Tracker blog, Faye Flam deftly uncovers the almost universal shallow coverage in the media.

The one exception, the one story worth reading that “dug into the science,” according to Flam, is Gina Kolata’s story in the New York Times:

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Click here to read the full post on Forbes.

 

English: A close up of salt crystals.

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The Mediterranean Diet: The New Gold Standard? 1

by • Policy & Ethics, Prevention, Epidemiology & Outcomes • Tags: , , , , ,

Earlier today I summarized the important new PREDIMED study published in the New England Journal of Medicine showing the cardiovascular benefits of the Mediterranean diet. This study– a rare and much welcome instance of a large randomized controlled study of a diet powered to reach conclusions about important cardiovascular endpoints– has been widely praised and will undoubtedly have a major effect in the field of nutrition and will influence lots of people to adopt some form of a Mediterranean diet.

The study’s major potential weakness appears to be that the control group didn’t get a fair chance.

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Dean Ornish, probably the best-known and most passionate advocate of low-fat diets, goes much further in attacking the credibility of the trial…

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The really great thing about the Mediterranean diet, by contrast, is that we know with 100% certainty that it is possible for people to live and eat this way, since they’ve been doing so for millennia. It’s true, though, that the new study didn’t really demonstrate that the Mediterranean diet is better than a true low-fat diet. But it did demonstrate that a Mediterranean diet is healthier than what most people are currently eating. So it’s a good example of a real world trial.

…Now that the Spanish PREDIMED study has been published, I think it must be considered the gold standard. Now it is up to the AHA, and Ornish, to prove that their diets are better than, or even as good as, the Mediterranean diet.

Click here to read the complete story on Forbes.

olive oil and almonds copy

Back To The Future: Resurrected Data From 1960s Trial Might Impact Contemporary Dietary Fat Debate 2

by • Policy & Ethics, Prevention, Epidemiology & Outcomes • Tags: , , , , , ,

In an exceedingly strange turn of events, data from a clinical trial dating from the 1960s, long thought to be lost, has now been resurrected and may contribute important new information to the very contemporary controversy over recommendations about dietary fat composition.

The American Heart Association has long urged people to increase their consumption of polyunsaturated fatty acids (PUFAs), including omega 6 PUFAs, and reduce their consumption of  saturated fatty acids. The recommendations are based on the simple observation that PUFAs lower total and LDL cholesterol while SFAs have the opposite effect. However, the cardiovascular effects of substituting PUFAs for SFAs have never been tested in randomized, well-controlled clinical trials, and a growing proportion of experts now suspect that simple changes in total cholesterol and LDL cholesterol may not tell the whole story.

One trial that actually tested the hypothesis was the Sydney Diet Heart Study, which ran from 1966 through 1973. In the trial, 458 men with coronary disease were randomized to a diet rich in linoleic acid (the predominant omega 6 PUFA in most diets) or their usual diet. Although total cholesterol was reduced by 13% in the treatment group during the study, all-cause mortality was higher in the linoleic acid group than in the control group. However, in the original publications, and consistent with the practice at the time, deaths from cardiovascular (CVD) and coronary heart disease (CHD) deaths were not published.

Now, in a new paper published in BMJ, Christopher Ramsden and colleagues report that they were able to recover and analyze data from the original magnetic tape of the Sydney Diet Heart Study. The new mortality findings are consistent:

Click here to read the full story on Forbes.

Delorean DMC-12

Large Meta-Analysis Finds No Harm Associated With Eggs 2

by • Policy & Ethics, Prevention, Epidemiology & Outcomes • Tags: , , , , ,

No food has had more ups and downs over the last century or so than the common egg. Following a long period in which eggs were ubiquitous and highly regarded, eggs fell from favor with the rise of concerns over cholesterol. Currently the American Heart Association recommends that people restrict dietary cholesterol to 300 mg per day, which effectively limits people to 1 egg per day at most. However, the relationship of dietary cholesterol and serum cholesterol  is, at best, tenuous, and a significant number of experts now believe that egg consumption poses no risk to cardiovascular health.

In a new paper published in BMJ, a group of researchers from China and Boston performed a meta-analysis of 8 studies that included 263 938 participants for coronary heart disease (CHD) and 210 404 participants for stroke and followed them for 8 to 22 years. The authors found no evidence for an association between egg consumption and either coronary heart disease or stroke…

Click here to read the full story on Forbes.

American Heart Association Lists Top 10 Research Advances Reply

by • Uncategorized • Tags: , , , , , ,

The AHA has published its annual list of the top 10 advances in heart disease and stroke research. It’s probably worth remarking that not a single item on the list is related to drug therapy. I haven’t gone back and checked past lists, but I would bet this hasn’t happened before.

Here’s the list:

  1. Extended CPR saves lives
  2. Converting “non beating” heart cells into “beating” heart cells
  3. Biopsied heart cells improved heart function and reduced scars
  4. “Disconnecting” the kidneys might be the key to treating high blood pressure
  5. Progress for children in transplant bridging and Kawasaki Disease
  6. Why children and adolescents should “just say no” to sugary drinks
  7. Global impact: ECHO screening for rheumatic heart disease
  8. Devices for stroke
  9. Ideal cardiovascular health practices lead to longer life, lower risk
  10. Bypass surgery vs. drug-coated stents for diabetes patients

Click here to read the full AHA press release. with full explanations and citations…

State Of The Heart: AHA Publishes Year-End Statistical Update Reply

by • Policy & Ethics, Prevention, Epidemiology & Outcomes • Tags: , , ,

Although deaths from cardiovascular disease have been declining for many years, continued progress is threatened by disturbing trends in US lifestyles. That’s the clear message from the American Heart Association’s year-end report, “Heart Disease and Stroke Statistical Update 2013,” published in Circulation.

“Americans need to move a lot more, eat healthier and less, and manage risk factors as soon as they develop,” said Dr. Alan S. Go, the chairman of the report’s writing committee, in an AHA press release. “If not, we’ll quickly lose the momentum we’ve gained in reducing heart attack and stroke rates and improving survival over the last few decades.”

Here are some of the key statistics contained in the hefty report:

“The Epidemic of Poor Health Behaviors”

  • Among adults, 21.2% of men and 17.5% of women continued to smoke cigarettes. 18.1% of high school students are smokers.
  • Among high school students, 17.7% of girls and 10.0% of boys reported they had less than one hour of moderate-to-vigorous exercise.
  • Thirty-three percent of adults reported engaging in no aerobic leisure-time physical activity.
  • From 1971 to 2004, calorie intake increased from 1542 to 1886 kcal/d (22%) in women and from 2,450 to 2,693 kcal/d (10%) in men. Most of the change is due to an increased consumtpion of starches, refined grains, and sugars.
  • 68.2% of adults are overweight or obese. 34.6% are obese.
  • 31.8% of children 2-19 years of age are overweight or obese. 16.9% are obese.

“Prevalence and Control of Health Factors and Risks Remains an Issue for Many Americans”

  • 13.8% of US adults have serum serum cholesterol levels ≥240 mg/dL.
  • 33.0% of US adults have hypertension. About 82% are aware of their condition, 75% receive antihypertensive therapy, but only a little more than half (53%) have achieved target blood pressure levels.
  • 8.3% of US adults have been diagnosed with diabetes. 38.2% have abnormal fasting glucose levels (prediabetes).

CV Disease and Mortality

  • Although the percentage of deaths attributable to CV disease has been declining for decades, in 2009 CV disease  was responsible for nearly one-third (32.3%) of all deaths in the US.
  • About 635,000 people have a first MI or CHD death each year. About 280,000 have a second MI.
  • About 795,000 people have a new or recurrent stroke each year.
  • The 2009 total direct and indirect estimated cost of CVD and stroke:  $312.6 billion.
  • The 2008 total direct and indirect estimated cost of all cancer and benign neoplasms: $228 billion

Click here to read the AHA press release:

Walking With the American Heart Association: Valerie Bertinelli and Chester Cheetah 1

by • People, Places & Events, Policy & Ethics • Tags: , , , ,

A few weeks ago Chester Cheetah, the official mascot for Frito Lay’s Cheetos, played an official part in  the American Heart Association’s Dallas Heart Walk. Yoni Freedhoff, on his Weighty Matters blog, pretty much says what needs to be said about this disgraceful association between Frito Lay and the AHA.

This weekend I received a press kit from Jenny Craig. The diet company was publicizing the participation of  tabloid celebrity Valerie Bertinelli, a Jenny Craig “brand ambassador,”  in the AHA’s Los Angeles Heart Walk on Saturday. At first glance, Jenny Craig’s relationship with the AHA does not appear to be as awful as Frito Lay’s. After all, whatever else you may think about the company and its methods, obesity is a major problem, and if some people can defy the odds and lose weight with Jenny Craig then all the better for them.

But the Jenny Craig relationship brings up another, more subtle harm caused by these sort of increasingly popular arrangements in which nonprofit organizations accept money from for-profit corporations. I was astonished to read the second paragraph of the Jenny Craig press release:

Bertinelli, who has lost weight on the Jenny Craig program, recognizes the importance of being in good heart health, and owes her mother’s life to Jenny Craig.  Bertinelli’s mother, Nancy, lost 54 pounds* on Jenny Craig after witnessing her daughter’s success on the program. In October of 2008, Bertinelli’s mother required emergency heart valve replacement surgery.  After the successful surgery, the cardiologist pulled Bertinelli and her brother aside and told them that if their mother hadn’t previously lost weight, she would not have survived the surgery.

Scientifically and medically, this is an entirely irresponsible statement, if in fact a cardiologist did make this statement. My source for this assertion? The AHA itself. Here’s what an AHA science advisory had to say about this exact topic:

Severe obesity has not been associated with increased mortality in patients undergoing cardiac surgery but has been associated with an increased length of hospital stay and with a greater likelihood of renal failure and prolonged assisted ventilation.

One of the most important roles of the AHA is to encourage, develop, and support the use of evidence-based medicine. Why then does the AHA agree to partner with companies that flagrantly (Frito Lay) or more subtly (Jenny Craig) undermine that effort?

Fun facts: Jenny Craig is a wholly owned subsidiary of Nestlé. Frito Lay is owned by Pepsi.

Related Stories:

Click here to read the Jenny Craig press release…

Subway Meals Get American Heart Association Endorsement 2

by • People, Places & Events, Policy & Ethics • Tags: , , , , , ,

The American Heart Association (AHA) announced today that it had initiated a new program that it claims will help people choose healthy meals at restaurants. The Subway restaurant chain will be the first to display the Heart-Check Meal Certification logo next to certain selected meals.

In a press release the AHA’s president, Gordon Tomaselli, said the program would make “it easy for consumers to make smart choices that are heart-healthy when eating outside the home, knowing they often don’t have the benefit of reviewing the nutrition facts.” The meal certification program is an expansion of the AHA’s Heart-Check Food Certification program, which was established in 1995.

Tomaselli told USA Today that certification can cost companies as much as $700,000 annually. ”But it’s not pay-to-play,” he told the paper. “The money is used to make sure what we’re telling the public is correct.”

The AHA certification logo will be displayed on Subway meals that meet the AHA’s nutritional criteria for levels of sodium, calories, cholesterol, saturated fat and trans-fats. But the new program does not mean that all meals certified by the program will necessarily be heart healthy, as noted on the Heart-Check Meal Certification webpage:

Is it still heart healthy to order my meal with mayonnaise or mustard?

  • The standard SUBWAY® 6-inch sandwiches that are part of the AHA (adult) certified meal are prepared on 9-grain wheat bread and contain the following vegetables: lettuce, tomatoes, onions, green peppers and cucumbers.
  • These sandwiches were evaluated without the addition of condiments such as mustard or mayonnaise. Adding condiments containing sodium (such as mustard) or fat (such as mayonnaise) may result in the meal no longer meeting AHA meal criteria.
  • Condiments such as mayo and mustard add saturated fat, sodium and cholesterol that can easily be avoided. These small choices throughout the day can help keep eating habits on track.
  • Additions such as pickles, cheese, and olives also make the sandwich less healthy.
  • Considering the freshness of the bread and the flavor and juiciness provided by the vegetables, these sandwiches are tasty without the addition of other toppings or condiments.

Subway said that it had been an AHA supporter for 12 years. On the AHA website, Subway is listed as a member of the Industry Nutrition Advisory Panel (INAP). Here is the mission of the INAP, according to the AHA website:

The American Heart Association (AHA) Industry Nutrition Advisory Panel (INAP) is a strategic relationship between the AHA Nutrition Committee and food industry leaders. INAP provides a platform for sharing information and planning cooperative programs in the areas of diet and nutrition and cardiovascular disease.

INAP industry members pay a $10,000 yearly membership fee to participate in meetings with “science representatives” from the AHA and other industry members. Here is the AHA description of the benefits of membership:

The primary benefit of INAP is bringing together industry and science representatives to exchange dialogues on areas of mutual interest pertaining to nutrition. Benefits of this dialogue include:

  • Networking and relationship building with industry leaders
  • Education on relevant topics from the nutrition, physical activity, metabolism and obesity areas
  • Members get the latest updates on all AHA initiatives and are given the opportunity to provide input to the AHA regarding statements and positions on these topics
  • Direct access to AHA staff involved in nutrition-related issues
  • An organized relationship with the Nutrition Committee that allows for open communication on topics of interest

Members also receive one complimentary registration to attend the AHA’s spring science conference and council dinner coordinated by the Nutrition, Physical Activity and Metabolism Council (NPAM) and the Council on Epidemiology (EPI).

In addition to Subway, some of the other members of INAP are Uniliver, Coca-Cola, Dr. Pepper, Frito-Lay, Hershey, Kellog, Kraft, McDonald’s, Sara Lee, The Sugar Assocaition, Welch’s, and Yumi Brands (Taco Bell, KFC, Pizza Hut).

Related Stories on CardioBrief:

AHA Scientific Statement Spotlights Peripheral Artery Disease in Women Reply

by • Prevention, Epidemiology & Outcomes • Tags: , , , ,

Although peripheral artery disease (PAD) raises the risk of heart disease and stroke, it often goes undiagnosed and untreated, especially in women, according to a scientific statement issued by the American Heart Association and published in Circulation.

Here are a few highlights of the statement:

  • Although women develop PAD later than men, the total number of women with PAD is greater than the number of men.
  • Like men, most women with PAD do not present with “classic symptoms” of intermittent claudication; rather, many are asymptomatic or have atypical leg symptoms.
  • Women with PAD are more likely than women without PAD to have greater functional impairment and a more rapid functional decline. Women, and black women in particular, have a greater risk for graft failure and limb loss than men.
  • Although women have slightly lower normal ABI levels than men, physicians should use the same diagnostic criteria for PAD in men and women.
  • Although the evidence is limited because of the underrepresentation of women in clinical trials, exercise training is equally effective in men and women.
  • At-risk women should be educated about PAD risk factors, symptoms, and cardiovascular risk by all healthcare providers.

“The rate of deaths and the healthcare costs associated with PAD are at least comparable to those of heart disease and stroke,” said the lead of the author of the AHA statement, Alan Hirsch, in an AHA press release. “Women, in particular, suffer an immense burden from peripheral artery disease, yet current data demonstrate most women still remain unaware of their risk.”

Adapted with permission from Physician’s First Watch.
Click here to read the AHA press release…