Healthy Diet and Lifestyle Cut MI Risk, Heart Failure

A new Swedish study looking at the benefit of a combination of several healthy lifestyle behaviors has found that most myocardial infarctions (MIs) in women could be prevented by consuming a healthy diet, being physically active, not smoking, and maintaining a healthy weight [1].

Dr Agneta Akesson (Karolinska Institute, Stockholm, Sweden) and colleagues report their findings in the October 22, 2007 issue of the Archives of Internal Medicine. They say there is little prior information on the benefit achieved with a combination of several healthy lifestyle behaviors. The results indicate that the combined benefit of diet, lifestyle, and healthy body weight "may prevent more than three of four cases of MI," they note.

"Our study shows the great effect you get from each of these and by combining them," Akesson told heartwire. "It's quite a simple health message, and you can do them by yourself."
In healthiest women, 92% decreased risk of MI

The Swedish researchers say coronary heart disease (CHD) risk-factor characterization and prevention in women need improvement, and despite the proven benefits of pharmacologic therapies, "diet and lifestyle largely influence morbidity and mortality in CHD."

One of the novel things the Swedish group did was to assess behavioral dietary patterns among the 24,444 postmenopausal women they studied, who were participating in the population-based prospective Swedish Mammography Cohort and who were free of diagnosed cancer, cardiovascular disease, and diabetes mellitus at baseline (September 15, 1997).

They identified four major dietary patterns: healthy (vegetables, fruits, and legumes); Western/Swedish (red meat, poultry, rice, pasta, eggs, fried potatoes); alcohol; and sweets (sweet baked goods, candy, chocolate). Those who consumed moderate amounts of alcohol (5 g or more a day; equivalent to a glass of wine every other day) were categorized as low risk. No upper limit for alcohol consumption was defined, because few women consumed high amounts of alcohol (less than 0.3% reported drinking more than 45 g/day). Those in the lowest-risk quintile for diet had an almost fourfold higher weekly consumption of vegetables and fruits, a threefold higher consumption of legumes, and a 70% higher consumption of fish compared with the highest-risk quintile.

During a mean of 6.2 years of follow-up, there were 308 incident cases of primary MI, of which 51 were fatal.

The researchers defined a low-risk dietary behavior based on high scores for the healthy dietary pattern (low-risk quintiles 3-5) and, when combined with moderate alcohol intake, this group had a significant 57% reduction in primary MI.

The researchers also defined three low-risk lifestyle factors: nonsmoking, waist/hip ratios less than the 75th percentile (<0.85), and being physically active.

The 5% of the study population who ate healthily, drank alcohol in moderation, and maintained these three low-risk lifestyle behaviors had a 92% decreased risk of MI compared with women without any low-risk diet and lifestyle factors.