This exchange illustrates how the medical community will cling desperately
to any forlorn hope that a "lifestyle" silver bullet will be found to
prevent heart disease while paying short -- if any attention -- to
absolutely proven effects of material deprivation across the life span on
the incidence of CVD. And of course such lifestyle discourse precules any
attention being directed to public policy solutions to address these issues
of material deprivation in developed and developing nations.
dennis
---------------------- Forwarded by Dennis Raphael/Atkinson on 10/27/2004
01:06 PM ---------------------------
"Pascal Bovet" <[log in to unmask]>@healthnet.org on 10/27/2004
09:27:01 AM
Please respond to Cardiovascular Health in the Developing World
<[log in to unmask]>
Sent by: [log in to unmask]
To: Cardiovascular Health in the Developing World <[log in to unmask]>
cc:
Subject: [ProCOR] Re: New study: Mediterranean-style diet reduces CVD
risk (6)
Even what seems almost certain (health benefit from omega 3 fatty acids) is
challenged!
According to a news in "inCirculation.net", Hooper et al carried a review
for The Cochrane Database of Systematic Reviews (Cochrane Library 2004: 4)
based on results in 48 trials involving a total of 36,913 participants and
41 cohort analyses that estimated omega-3 intake in around 563,218 people
for at least 6 months.
They found that increasing intake of omega-3 fats had no significant effect
on triglyceride levels, total, high-density or low-density lipoprotein
cholesterol levels, or blood pressure. In addition, the risk of total
mortality or combined cardiovascular events did not differ between people
with high or low omega-3 intake. Hooper et are quoted to state that "It is
not clear that dietary or supplemental omega-3 fats alter total mortality,
combined cardiovascular events or cancers in people with, or at high risk
of, cardiovascular disease or in the general population." However, they
suggest that "people should not be advised to stop taking rich sources of
omega-3 fats".
Pascal Bovet, Lausanne, Switzerland
At 27-10-2004 18:09, you wrote:
>Further reinforcement of the Mediterrean diet (see Dr Roberts' commentary
>on the JAMA article 292:1440-1446) arrives as the FDA allows labels of
>foods containing omega-3 fatty acids (primarily fish) to say that they may
>reduce the risk of coronary heart disease.
>
>The label will read: "Supportive but not conclusive research shows that
>consumption of EPA and DHA omega-3 fatty acids may reduce the risk of
>coronary disease."
>
>The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic
>acid (DHA) will be quantitated based on the number of grams provided per
>serving. How this occurs, and how accurate these measurements
>are, is not entirely clear to me. Any further information about this
>process, the relative proportions of EPA and DHA, would be greatly
>appreciated. It would also be interesting to learn more about the
>relative availability and cost of fish around the world.
>
>Thank you for any help you may provide.
>Susanna Bedell, MD
>
>-----Original Message-----
>From: [log in to unmask]
>To: Cardiovascular Health in the Developing World
>Sent: 10/21/04 7:26 PM
>Subject: [ProCOR] Re: New study: Mediterranean-style diet reduces CVD risk
(4)
>
>This is indeed encouraging news, but given the natural history of other
>"successful"
>diets (like Atkins), I hope there will be follow up of this group to
>see how they are
>doing in five years.
>Susanna Bedell
>
>Barbara Roberts wrote:
>
> >The September 22/29 issue of JAMA contains an article entitled 'Effect
>of
> >Mediterranean-Style Diet on Endothelial Dysfunction and Markers of
>Vascular
> >Inflammation in the Metabolic Syndrome' by Katherine Esposito, et al.,
>(JAMA
> >2004; 292: 1440-1446).
> >
> >The authors randomized 180 adults with the metabolic syndrome (99 men
>and 81
> >women) to a single blind, randomized trial of the Mediterranean diet.
>Patients
> >in the intervention group were given instruction in increasing their
>daily
> >intake of whole grains, fruits and vegetables, nuts and olive oil.
>Patients in
> >the control group followed a prudent diet containing 50-60%
>carbohydrates,
> >15-20% protein and total fat < 30% of calories. The participants had
>three or
> >more criteria for the metabolic syndrome, which include increased
>abdominal
> >waist circumference (> 102 cm in men, >88 cm in women), high blood
>pressure
> >(130/85 or greater), glucose intolerance (fasting glucose of 110 mg/dl
>or
> >greater), low HDL cholesterol levels (< 40 mg/dl in men, < 50 mg/dl in
>women),
> >and hypertriglyceridemia (triglyceride level 150 mg/dl or greater).
>Participants
> >were instructed to monitor their intake in a daily food diary over a
>two-year
> >period.
> >
> >The study found that after two years the intervention group had
>significant
> >decreases in body weight, body mass index, waist circumference, blood
>pressure,
> >levels of hs-CRP, glucose, insulin, total cholesterol, and
>triglycerides and
> >significant increases in HDL cholesterol and indices of endothelial
>function
> >compared to the control group, regardless of gender.
> >
> >The authors point out that their study was the first demonstration, to
>their
> >knowledge, that a Mediterranean-style diet might be effective in
>reducing both
> >the prevalence of the metabolic syndrome and its associated
>cardiovascular risk.
> >
> >Emily Clarke-Pearson, MD '07, Brown Medical School
> >Barbara H. Roberts, MD, Women's Heart Health Editor, ProCOR
> >_____________________________________________________________________
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Engage others in the discussion by forwarding this message to colleagues.
We welcome new participants! Subscribing is free--simply send an email to
<[log in to unmask]>.
Questions, comments? Send feedback to Catherine Coleman, Editor in Chief,
ProCOR
<[log in to unmask]>.
ProCOR (www.procor.org) is a program of the Lown Cardiovascular
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(www.healthnet.org), The Global Health Information Network.
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