How Important Is Diet To Your Health?

How Important Is Diet To Your Health?

To avoid cardiometabolic diseases like heart disease, diabetes, and stroke, there’s likely nothing more important than following a healthy diet, asserts newly published research in the Journal of the American Medical Association (JAMA).¹

Using data that dissected the diets of 702,308 American adults who died from cardiometabolic diseases, the scientists found that nearly half of those deaths – 45.4% – were linked with 10 dietary factors.

The “Bad”

Four of these factors were “bad.” The more you ate of them, the deadlier their impact. They were:

• Salt
• Sugar-sweetened beverages
• Processed meats (such as cold cuts, sausages, bacon, and hot dogs), and
• Unprocessed meats (such as beef and pork)

The “Good”

The remaining six were “good” dietary factors. If you didn’t eat enough of them, you got into trouble. They were:

• Fruits
• Vegetables
• Fish as a rich source of omega-3 fatty acids
• Whole grains
• Nuts and seeds, and
• Polyunsaturated fats (as a replacement for saturated fats and refined carbohydrates). Foods rich in polyunsaturated fats include fish and some nuts and seeds, such as walnuts, sunflower seeds, and flaxseeds.

Poor diet is associated with a larger proportion of deaths among men than women.[/caption]

Men At Greater Risk

The study also found that poor diet was associated with a larger proportion of deaths among men (49%) than women (42%).

In men, the top five dietary factors tied with cardiometabolic deaths were:

1. Excess processed meats
2. Excess sodium
3. Excess sugar-sweetened beverages
4. Insufficient nuts/seeds
5. Insufficient seafood omega-3 fats

In women, the top five factors were:

1. Excess sodium
2. Insufficient nuts/seeds
3. Insufficient vegetables
4. Insufficient fruits
5. Insufficient seafood omega-3 fats

Poor diet was also linked with a larger proportion of deaths among blacks and Hispanics versus whites, and among people with lower versus higher levels of education.

Limitations

The authors, led by Renata Micha, PhD, RD, at Tufts University, acknowledged the limitations of their research. Most notably, theirs was an observational study, which means they could establish correlations between foods and diseases, but not cause-and-effect.

And yet, pointed out the authors, their findings were consistent with many prior U.S. studies of diet and cardiometabolic death.

For example, a large analysis² by researchers at Harvard School of Public Health concluded that dietary factors contributed to “a substantial number of deaths in the U.S.” in the year 2005 alone. A high-sodium diet was associated with 102,000 cardiovascular deaths; a low intake of omega-3 fats, with 84,000 deaths; a high intake of trans fats, with 82,000 deaths; and low consumption of fruits and vegetables, with 58,000 deaths.

In global analyses of deaths related to diets high in sodium³ and diets high in sugar-sweetened beverages⁴ in 2010, about 58,000 U.S. cardiometabolic deaths were linked with excess sodium, and about 24,000 were linked with sugar-sweetened beverages.

Proven Benefits of a Heart-Healthy Diet

Moreover, in 100-plus studies published over the last 36 years, “We have found that regular exercise and a healthy diet, the Pritikin Eating Plan, yielded fast and profound improvements in cardiometabolic risk factors,” states UCLA distinguished professor emeritus James Barnard, PhD.  Dr. Barnard was lead author of many of the Pritikin studies.

Results of the Pritikin Program of diet and exercise include:

• Reducing several risk factors⁵ for heart disease, including cholesterol, triglycerides, and inflammatory factors like C-reactive protein⁶
• Reducing blood pressure to normal or near-normal levels, and without the need for medications⁷
• Lowering blood sugar (glucose) in people with diabetes⁸ and reversing conditions like pre-diabetes and metabolic syndrome⁹
• Shedding excess weight¹⁰

The Right Dietary Factors?

A second concern regarding the published JAMA study is whether the 10 dietary factors selected were the right set “or whether some other dietary factors should be included and others removed,” pointed out Drs. Noel Mueller and Lawrence Appel of Johns Hopkins University in an editorial¹¹ in the same issue of JAMA.

• Saturated Fat

  “For example, should saturated fat have been included among the dietary factors?” Randomized trials (a gold-standard study design that does prove cause-and-effect relationships) have in fact demonstrated that replacing saturated fat with polyunsaturated vegetable oil reduced cardiovascular disease events by 18 to 41%.^{12, 13, 14}

• Trans Fats, Sugar

  Drs. Mueller and Appel also contend that strong arguments could be made for the inclusion of trans fats (also known as partially hydrogenated oils) and refined sugar in general (not just sugary beverages). Excess intakes of both are consistently linked with increased risk of cardiometabolic diseases and death.

• Potassium-Rich Foods

  Another possible factor on the “good” side of the dietary spectrum, they offered, was increased intake of foods rich in potassium, such as beans, dark leafy greens, baked potatoes with the skin on, squash, yogurt, mushrooms, and bananas.

• Nuts and Seeds | Overrated?

  Also, asserted Drs. Mueller and Appel, “many cardiometabolic prevention experts might argue that the effects of nuts and seeds [second highest risk in the JAMA study] are overestimated.”

How Important Is Diet To Your Health? | Bottom Line

Overall, concluded the JAMA study’s lead author Dr. Renata Micha and co-authors, diet matters in a very big way.

“Dietary factors were estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes. These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health.”

Concurred Drs. Mueller and Appel in their editorial: “…the likely benefits [of improved diet] are substantial and justify policies designed to improve diet quality.”

Salt: “A key target”

“Among unhealthful foods/nutrients, the present findings suggest that sodium is a key target,” summed up Dr. Micha and colleagues.

“Population-wide salt reduction policies that include a strong government role to educate the public and engage industry to gradually reduce salt content in processed foods (for example, as implemented in the United Kingdom and Turkey) appear to be effective, equitable, and highly cost-effective or even cost-saving.”^{15, 16}

Sources

• ¹ JAMA, 2017; 317(9): 912.
• ² PLoS Medicine, 2009; 6(4) :e1000058. doi: 10.1371/journal.pmed.1000058. Epub 2009 Apr 28.
• ³ New England Journal of Medicine, 2014; 371(7): 624.
• ⁴ Circulation, 2015; 132(8): 639.
• ⁵ Archives of Internal Medicine, 1991; 151:1389.
• ⁶ Journal of Applied Physiology, 2006; 100: 1657.
• ⁷ Journal of Applied Physiology, 2005; 98: 3.
• ⁸ Diabetes Care, 1994; 17: 1469.
• ⁹ Circulation; 2002; 106: 2530.
• ¹⁰ Archives of Internal Medicine, 1991; 151:1389.
• ¹¹ JAMA, 2017; 317(9): 908.
• ¹² Circulation. 1970; 42(5): 935.
• ¹³ Lancet,1968; 2(7577): 1060.
• ¹⁴ Lancet, 1972; 2(7782): 835.
• ¹⁵ Public Health Nutrition, 2012; 15(2): 254.
• ¹⁶ British Medical Journal, 2017; 356: i6699.