Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians

Risiko kejadian penyakit jantung iskemik 32% lebih rendah pada Vegetarian dibanding non-vegetarian. Antara lain disebabkan 1.indeks massa tubuh lebih kecil ; 2.kolesterol non-HDL lebih rendah ; 3.sistolik lebih rendah.

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Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study

Francesca L Crowe, Paul N Appleby, Ruth C Travis, and Timothy J Key

Abstract

Background: Few previous prospective studies have examined differences in incident ischemic heart disease (IHD) risk between vegetarians and nonvegetarians.
Objective: The objective was to examine the association of a vegetarian diet with risk of incident (nonfatal and fatal) IHD.
Design: A total of 44,561 men and women living in England and Scotland who were enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC)–Oxford study, of whom 34% consumed a vegetarian diet at baseline, were part of the analysis. Incident cases of IHD were identified through linkage with hospital records and death certificates. Serum lipids and blood pressure measurements were available for 1519 noncases, who were matched to IHD cases by sex and age. IHD risk by vegetarian status was estimated by using multivariate Cox proportional hazards models.
Results: After an average follow-up of 11.6 y, there were 1235 IHD cases (1066 hospital admissions and 169 deaths). Compared with nonvegetarians, vegetarians had a lower mean BMI [in kg/m2; −1.2 (95% CI: −1.3, −1.1)], non-HDL-cholesterol concentration [−0.45 (95% CI: −0.60, −0.30) mmol/L], and systolic blood pressure [−3.3 (95% CI: −5.9, −0.7) mm Hg]. Vegetarians had a 32% lower risk (HR: 0.68; 95% CI: 0.58, 0.81) of IHD than did nonvegetarians, which was only slightly attenuated after adjustment for BMI and did not differ materially by sex, age, BMI, smoking, or the presence of IHD risk factors.
Conclusion: Consuming a vegetarian diet was associated with lower IHD risk, a finding that is probably mediated by differences in non-HDL cholesterol, and systolic blood pressure.

Effect of Legumes as Part of a Low Glycemic Index Diet on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus

Pada diabetesi tipe 2, konsumsi polong (low glicemic index diet) memperbaiki kontrol glikemik dan menurunkan risiko penyakit jantung koroner.

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Effect of Legumes as Part of a Low Glycemic Index Diet on Glycemic Control and Cardiovascular Risk Factors in Type 2 Diabetes Mellitus A Randomized Controlled Trial

David J. A. Jenkins, MD; Cyril W. C. Kendall, PhD; Livia S. A. Augustin, PhD; Sandra Mitchell, RD; Sandhya Sahye-Pudaruth, RD; Sonia Blanco Mejia, MD; Laura Chiavaroli, MSc; Arash Mirrahimi, MSc; Christopher Ireland, BSc; Balachandran Bashyam, PhD; Edward Vidgen, BSc; Russell J. de Souza, ScD; John L. Sievenpiper, MD; Judy Coveney, RD; Lawrence A. Leiter, MD; Robert G. Josse, MD

 

Arch Intern Med. 2012;():1-8. doi:10.1001/2013.jamainternmed.70

Background  Legumes, including beans, chickpeas, and lentils, are among the lowest glycemic index (GI) foods and have been recommended in national diabetes mellitus (DM) guidelines. Yet, to our knowledge, they have never been used specifically to lower the GI of the diet. We have therefore undertaken a study of low-GI foods in type 2 DM with a focus on legumes in the intervention.

Methods  A total of 121 participants with type 2 DM were randomized to either a low-GI legume diet that encouraged participants to increase legume intake by at least 1 cup per day, or to increase insoluble fiber by consumption of whole wheat products, for 3 months. The primary outcome was change in hemoglobin A_1c (HbA_1c) values with calculated coronary heart disease (CHD) risk score as a secondary outcome.

Results  The low-GI legume diet reduced HbA_1c values by −0.5% (95% CI, −0.6% to −0.4%) and the high wheat fiber diet reduced HbA_1c values by −0.3% (95% CI, −0.4% to −0.2%). The relative reduction in HbA_1c values after the low-GI legume diet was greater than after the high wheat fiber diet by −0.2% (95% CI, −0.3% to −0.1%; P < .001). The respective CHD risk reduction on the low-GI legume diet was −0.8% (95% CI, −1.4% to −0.3%; P = .003), largely owing to a greater relative reduction in systolic blood pressure on the low-GI legume diet compared with the high wheat fiber diet (−4.5 mm Hg; 95% CI, −7.0 to −2.1 mm Hg; P < .001).

Conclusion  Incorporation of legumes as part of a low-GI diet improved both glycemic control and reduced calculated CHD risk score in type 2 DM.

Mild Hypertension: Garlic, Drugs, or Cocoa?

Information sourced from BMJ:

BMJ 2012;345:e5450 

Research News

All you need to read in the other general journals

[EXCERPT]

Garlic, drugs, or cocoa for hypertension?

Cochrane Database Syst Rev2012;8:CD006742 [PubMed® abstract | Cochrane Library abstract PDF]

Cochrane Database Syst Rev2012;8: CD007653 [PubMed® abstract | Cochrane Library abstract PDF]

Cochrane Database Syst Rev2012;8:CD008893 [PubMed® abstract | Cochrane Library abstract PDF]

One review of four trials that comprised nearly 9000 participants looked at how well antihypertensive drugs prevent cardiovascular events and death in people with mild hypertension, defined as systolic blood pressure of 140-159 mm Hg or diastolic pressure 90-99 mm Hg (or both). All participants were free of cardiovascular disease at baseline.

No effects were seen over four to five years, compared with placebo, for overall mortality (relative risk 0.85, 95% CI 0.63 to 1.15), coronary heart disease (1.12, 0.80 to 1.57), stroke (0.51, 0.24 to 1.08), or total cardiovascular events (0.97, 0.72 to 1.32). One in 10 people stopped taking antihypertensives because of adverse effects, a fivefold increase over placebo. The review did not report effects of drugs on blood pressure, if any.

Another review found two small trials that compared garlic powder with placebo in people with mild hypertension. Garlic might help reduce blood pressure—possibly by about 10 mm Hg for systolic blood pressure and a little less for diastolic blood pressure. However, the confidence intervals were wide, and no data were available on which to assess the potency of garlic to prevent cardiovascular events.

Cocoa is rich in flavanols, which cause blood vessel dilatation and are thought to reduce blood pressure. Most of the 20 trials (about 850 participants) tested a daily dose of 500-750 mg of flavanols ingested through chocolate or cocoa products. Most participants were healthy and normotensive at baseline, and most trials lasted only about a month.

Small reductions in blood pressure were seen with cocoa, compared with placebo: −2.77 (−4.72 to −0.82) mm Hg for systolic pressure and −2.20 (−3.46 to −0.93) mm Hg for diastolic blood pressure. One in 20 people allocated cocoa had adverse effects, compared with one in 100 of those receiving placebo. Gastrointestinal effects and a dislike of the product's taste were the most common problems.

© 2012 BMJ Publishing Group Ltd

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