Monthly Archives: February 2019

Worried About Your Heart? Don’t Skip Breakfast!

Today’s post is another in recognition of American Heart Month. Many of us can recall being reminded by our mother to “eat your breakfast” when we were young, usually as teenagers. It turns out that as is usually the case, mom was giving us good advice.

An interesting study from a research group primarily located in Spain and the US used data from PESA (Progression of Early Subclinical Atherosclerosis) and looked at the association of breakfast styles and cardiovascular risk factors and the presence of subclinical atherosclerosis.

The PESA study is an ongoing observational investigation of over 4000 employees who work at the Bank Santander Headquarters in Madrid, Spain. Female and male participants in the study were ages 40-54, and were free from cardiovascular disease at the time of enrollment in the study. The participants were asked to complete a computerized food questionnaire, which included over 800 food items. Based on this data the “energy consumed during breakfast” was calculated.

Three different categories of breakfast patterns were established. First were the “breakfast skippers”, whose breakfast intake did not exceed 5% of the their total daily energy intake. The next category was the “low energy” breakfast group, who consumed between 5% and 20% of their total daily energy intake at breakfast. The third group was the “high energy” breakfast group which consisted of those who consumed more than 20% of their total energy intake at breakfast. Of the over 4000 study subjects, 3% were in the “breakfast skipper” group, 69% were in the “low energy” group, and 28% were in the “high energy” breakfast group.

Ultrasound was used to assess for atherosclerotic plaques in the carotids, the abdominal aorta, and the illiofemoral arteries. The prevalence of subclinical atherosclerosis for the PESA subjects was 62.5% in the “breakfast skippers” group, 60.3% in the “low energy” group, and 13.4% in the “high energy” group.

Importantly, regularly skipping breakfast was associated with 2.57 higher odds for generalized atherosclerosis, and 1.55 higher odds for noncoronary atherosclerosis, independent of traditional cardiovascular risk factors (such as diabetes, high cholesterol, high blood pressure, and smoking).

So, make some time in the morning for breakfast. It turns out mom was right, again.

“Sometimes I’ve believed as many as six impossible things before breakfast”. Lewis Carroll

(Source- Journal of the American College of Cardiology, Vol. 70, No. 15, 2017)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Adding Sugar Increases Cardiovascular Events

February is National Heart Health Month. In honor of heart health, and Valentine’s Day, this post is about cardiovascular disease

In this study published in JAMA Internal Medicine in 2014 researchers looked at the effect of added sugar in the American diet and its relationship to cardiovascular disease. Participants who consumed 17-21% of calories from added sugar had a 38% higher risk of cardiovascular mortality, compared to those who only consumed 8% of calories from added sugar. For those who consumed 21% or more of calories from added sugar, the relative risk was doubled.

Much of the added sugar in the American diet is from soda, other sources include desserts, fruit juices and candy. Just one soda a day constitutes 7% of the total calories of a 2000 kcal/day diet.

The reason for increased cardiovascular risk with increasing sugar intake is probably due to several causes, such as obesity, increased blood pressure, worsening cholesterol, and higher inflammation in the body.

This is a robust study which looked at data from the National Health and Nutrition Examination Survey (NHANES) which is felt to be a nationally representative sample of US adults. It provides more solid evidence of the harms of sugar and simple carbs to cardiovascular health. Happy Valentine’s!

“Wherever you go, go with all your heart.”  Confucius

(Source- JAMA Internal Medicine, April 2014, Volume 174, Number 4)

An Orange a Week May Prevent Macular Degeneration

February is AMD/Low Vision Awareness Month, and in recognition of this our post today will examine the effects of dietary flavonoids on age-related macular degeneration (AMD).

Age-related macular degeneration is one of the leading causes of vision loss in the US. It is estimated that approximately 1.75 million Americans age 40 and older suffer with macular degeneration. The World Health Organization ranks AMD as the third leading cause of blindness worldwide, after cataracts and glaucoma. AMD is characterized by the loss of the central field of vision. Risk factors for AMD include advanced age, smoking, high blood pressure, and a diet low in fruits and vegetables. Family history is also a factor.

Foods that are considered to be good sources of flavonoids include apples, blueberries, brocoli, cabbage and chocolate (make that dark chocolate) and tea. In turn, flavonoids can be sub-divided into six classes including anthocyanins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones.

A research group in Australia examined the association of dietary intake of flavonoids and the subsequent development of age-related macular degeneration. Over 2800 subjects were enrolled at baseline, and over 2000 were followed up to 15 years. Dietary information was collected via a 145-item self-administered food frequency questionnaire. The sum of the flavonoid compound for each food was computed. Enrollees in the study were invited to follow-up at 5 years, 10 years and finally 15 years.

The researchers found a protective and significant association between the total flavonoids intake, and in addition the total flavonol and total flavanone intake, and AMD prevalence. Interestingly, those participants who consumed at least one serving of oranges a week but less than one serving each day had reduced odds of 92% of the development of late AMD, compared to those who did not consume any oranges.

Given the commonality of AMD, incorporating some simple dietary choices into your daily regimen seems like an easy intervention. In particular, finding time to eat an orange or two a week could be very beneficial.

“Orange is the happiest color”.  Frank Sinatra

(Source- American Journal of Clinical Nutrition 2018; 108)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone.