Tuesday, December 24, 2013

Vitamin D deficiency linked to 62% increased risk for fatal Cardio Vascular Disease, 27% increased risk for Coronary Heart Disease

Vitamin D Deficiency Linked to Fatal Cardio Vascular Disease

Miriam E. Tucker
December 23, 2013

HEIDELBERG, GERMANY — Vitamin D deficiency is much more strongly linked to fatal than nonfatal CV events, results of a large prospective study suggest [1].
“Although our results were able to confirm an approximately 27% increased total CV risk in subjects with vitamin D deficiency, they indicate that the risk is much stronger for (and possibly even confined to) fatal CVD events,” write the researchers, led by cofirst authors Drs Laura Perna and Ben Schottker, German Cancer Research Center (Heidelberg).
The findings were published in the December issue of the Journal of Clinical Endocrinology and Metabolism.

Previous observational and randomized trials linking serum 25-hydroxyvitamin D (25(OH)D) concentrations with increased CVD risk have typically used only a single vitamin D measurement and did not separately examine fatal and nonfatal outcomes, they note.
The current population-based cohort study enrolled 9949 adults aged 50 to 74 years recruited during regular health check-ups at primary-care practices in 2000 to 2002. There were more women than men (59% vs 41%); most participants (59%) had inadequate vitamin D levels (<50 nmol/L). Blood samples were collected at baseline, five, and eight years.
Mean follow-up was 9.2 years for mortality and 6.5 years for the end points of Cardio Vascular Disease,CVD, Coronary Heart Disease, CHD, and stroke. A total of 854 patients had a nonfatal CVD event, 176 had a fatal CVD event, 460 had a nonfatal CHD event, 79 had a fatal CHD event, 313 had a nonfatal stroke, and 41 had a fatal stroke.
Overall, the proportion of individuals who had no events was significantly lower among those with vitamin D deficiency. The association continued after adjustment for age, sex, and season of blood drawn, with hazard ratios ranging from 1.46 for total CVD to 1.58 for total stroke.
Even after adjustment for other potential confounders, including smoking and physical activity, vitamin D deficiency still conferred a significant 27% increased risk for total CVD, and a 62% increased risk for fatal CVD. However, there was no association between vitamin D deficiency and nonfatal CVD events.
Individuals with low vitamin D levels also had a significant 36% increased risk of total CHD and a nonsignificant 33% increased risk of total stroke.
A possible explanation for the stronger association between 25(OH)D and CVD mortality than nonfatal CVD end points is that low vitamin D levels could lead to more severe events and perhaps also reduce capacity to cope with the events. Alternatively, the association of 25(OH)D with mortality may be more strongly affected by confounders linking to both low vitamin D and poor health status, such as diabetes or chronic kidney disease, the authors suggest.
This study was funded by the State Ministry of Science, Research, and Arts of Baden–Württemberg; German Cancer Aid (project 108250), and CHANCES project, funded in the FP7 framework program of DG-RESEARCH, European Commission (grant 242244). The authors have disclosed no relevant financial relationships.

Saturday, December 21, 2013

Americans Have Little Faith In Scientists, Science Journalists: Poll


get the facts right in their stories about scientific studies.

78% of Americans think that information reported in scientific studies is often (34 percent) or sometimes (44 percent) influenced by political ideology

The HuffPost/YouGov poll was conducted Nov. 23-24 among 1,000 U.S. adults using a sample selected from YouGov's opt-in online panel to match the demographics and other characteristics of the adult U.S. population. Factors considered include age, race, gender, education, employment, income, marital status, number of children, voter registration, time and location of Internet access, interest in politics, religion and church attendance.

How much faith do Americans have in scientists and science journalists? Not a whole lot, a new survey finds.

In a new HuffPost/YouGov poll, only 36 percent of Americans reported having "a lot" of trust that information they get from scientists is accurate and reliable. Fifty-one percent said they trust that information only a little, and another 6 percent said they don't trust it at all.
Science journalists fared even worse in the poll. Only 12 percent of respondents said they had a lot of trust in journalists to get the facts right in their stories about scientific studies. Fifty-seven percent said they have a little bit of trust, while 26 percent said they don't trust journalists at all to accurately report on scientific studies.
What’s more, many Americans worry that the results of scientific studies are sometimes tainted by political ideology -- or by pressure from the studies’ corporate sponsors.
A whopping 78 percent of Americans think that information reported in scientific studies is often (34 percent) or sometimes (44 percent) influenced by political ideology, compared to only 18 percent who said that happens rarely (15 percent) or never (3 percent).
Similarly, 82 percent said that they think that scientific findings are often (43 percent) or sometimes (39 percent) influenced by the companies or organizations sponsoring them.
Republicans in the new poll were most likely to say that they have only a little bit of trust in scientists to give accurate and reliable information, and the most likely to say that they think scientific findings may be tainted by political ideology -- possibly reflecting distrust in scientists over topics such as evolution and climate change.

Related Story

Editor's note:These "studies" are actually meta-studies, meaning that they take a number of somewhat similar studies done by others in a defined period and lump them all together. For researchers, this is a great new way to get grants and other money without having to actually spend any money doing research. They still get to call it research though. They also get to massage the data of 30 studies with different parameters and reporting to make it all come out right.

“Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”

This week, the Annals of Internal Medicineone of the world’s leading medical journals—published three studies evaluating the benefits of vitamins and dietary supplements.
The first study determined whether healthy people who received daily multivitamins had a lesser incidence of cancer or heart disease and whether they lived longer. The study was quite large, involving about 400,000 adults. Study participants were randomly divided into two groups: One group received daily multivitamins; the other didn’t. The authors found no difference in any medical outcome.
The second study examined about 6,000 men older than 65 to see whether daily multivitamins improved cognitive performance or verbal memory. The group that received multivitamins was indistinguishable from the group that didn’t.
The third study examined about 1,700 men and women with a history of a heart attack to see whether multivitamins could prevent another cardiac episode. Patients were followed for about five years. The study was limited by a high dropout rate, but again, multivitamins did nothing to prevent heart attacks in those at highest risk.
In the editorial that accompanied these studies, the authors summarized the evidence. “Beta-carotene, Vitamin E, and possibly high doses of Vitamin A supplements are harmful,” they wrote. “Other antioxidants, folic acid, and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.” In other words, megavitamins (which contain quantities in excess of the Recommended Daily Amount, or RDA) were potentially harmful, and multivitamins (which contain at or around the RDA) were useless. The title of the editorial wasn’t subtle: “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”

Monday, December 16, 2013

Readers Digest - Heart Disease Risk Factor #1: Nitric Oxide

Heart Disease Risk Factor #1: Nitric Oxide
The role of nitric oxide in cardiovascular health.

from Cut Your Cholesterol

The same chemical responsible for men’s erections (and, indirectly, for the success of Viagra) also plays a vital role in the health of your arteries, and thus your heart.
The chemical is nitric oxide (NO), which is primarily produced in the blood vessels’ endothelium, or lining. There it increases blood flow, prevents fatty deposits from sticking to blood vessel walls, keeps walls from getting too thick and stiff, and prevents the arteries from narrowing.
“The lining of the vessel is very important for cardiac health,” says John P. Cooke, M.D., Ph.D., head of Stanford University’s vascular unit and one of the first researchers to pinpoint the role of NO in cardiovascular health. “When the endothelium is healthy it’s like Teflon, and things don’t stick.” When it’s unhealthy, it becomes more like Velcro, attracting blood-borne gunk like flies to flypaper.
All of the major culprits in heart disease — overweight, lack of exercise, smoking, high cholesterol, high blood pressure, high levels of homocysteine and lipoprotein (a) — damage the endothelium. And a damaged endothelium doesn’t make enough NO, which results in more damage in an increasingly dangerous spiral. “But we can restore endothelial health and the lining of the vessel through exercise and nutrition,” Dr. Cooke says. Certain nutritional supplements (like arginine) and drugs used to treat heart disease (like aspirin and statins) can also help.
By the Numbers
If doctors could measure endothelial function — how blood vessels behave — they would have a good indication of your nitric oxide production, and in fact, your overall risk for coronary heart disease (CHD). Measuring endothelial function is like asking your arteries, “How’s it going?” If the answer is “well,” your arteries are happy with the composition of the blood and are probably relatively free of plaque.
Doctors can measure endothelial function in various ways, most of which involve using ultrasound to measure changes in the diameter of certain arteries. This testing is usually used for research purposes only. But soon there may be a way to test endothelial function right in the doctor’s office. In late 2000 the FDA approved a new, noninvasive instrument called CVProfilor DO-2020 that can measure the elasticity of your arteries, an indication of NO production. Normal ranges vary depending on your age and sex. The test isn’t in routine use yet, but that day may be coming.
Quick Tips
Eat more foods that contain the amino acid arginine, from which NO is produced. This includes beans, soy, almonds, walnuts, oats, and such cold-water fish as salmon, tuna, and mackerel.
Cut your intake of saturated fat. Just one meal high in saturated fat can temporarily cut endothelial function almost in half.
Exercise. The increased blood flow that occurs during exercise encourages the endothelium to make more NO. Over the long term, if you exercise every day, your endothelial cells not only release more NO but also make more of the enzyme that converts arginine into NO.

Monday, September 23, 2013

Risk of developing cataracts was 29% higher in the statin users

Sep 20, 2013

Risk of developing cataracts was 29% higher
in the statin users


The meta-analysis published today, ... matched 6972 statin users with nonusers within the San Antonio Military Multi-Market Area health system using propensity scores based on variables that increased the likelihood of receiving statins and increased the risk of developing cataracts. Statin users had to have been on the drugs for more than 90 days; simvastatin was prescribed in almost three-quarters of the patients.
In secondary analyses that looked at all patients with no comorbidities* (see definition below) ... at baseline, the risk of developing cataracts was 29% higher in the statin users. Results were consistent regardless of whether patients had been taking statins for two, four, or six years, authors note. They found that statin users in the propensity-matched analysis had a 9% increase in cataracts. 
* In medicinecomorbidity is either the presence of one or more disorders (or diseases) in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.

Friday, August 9, 2013

Alice G. Walton, ContributorI cover health, medicine, psychology and neuroscience.

From the editor, Scott Norton
Here's the short story. It's the flavanols in chocolate that improve circulation in the brain. Flavanols are antioxidants. So how do antioxidants improve blood circulation in the brain? It's all pretty simple and goes back to impaired endothelial function in your arteries.
Oxidation damages endothelial function and reduces nictric oxide levels. Increase your antioxidant intake and you get more nitric oxide and better circulation. Or as this article puts it. "... any improvement in blood flow could be reflected in cognition. “We’re learning more about blood flow in the brain and its effect on thinking skills,”.
It's no coincidence that ProArgi-9+ has two powerful antioxidants, resveratrol and pomegrante. ProArgi-9+ increases nitric oxide levels by supplementing L-arginine, which is used to make NO and providing antioxidants to prevent damage to the endothelial layer of the arteries.
This is why people who have dementia and Alzheimer's often respond so well with ProArgi-9+.

8/08/2013 @ 10:23AM |22,637 views

What's In Chocolate, Cocoa That Might Benefit Brain Health?

(Photo credit: Wikipedia)

There’s nothing much more alluring than a headline touting the health benefits of chocolate – and if they have to do with protecting the brain, most of us are sold. There’s been a lot of research in this area, with some studies strongly suggesting that compounds in cocoa may reduce the risk for age-related cognitive decline, or, possibly, even reverse it once it occurs. The problem is that no one can quite pin down why it might be good for the brain, though certain mechanisms are good candidates. Now, a new study in Neurology goes a little further in teasing apart the mechanisms that may be involved in the chocolate-brain relationship. And though the researchers aren’t recommending we all increase our cocoa consumption just yet, there do appear to be certain compounds in cocoa that are worth paying attention to.

In the new study, the team from Harvard randomly assigned 60 elderly people to drink two cups of flavanol-rich or flavanol-poor cocoa every day for a month. Flavanols are a type of polyphenol – antioxidants found in foods like cocoa, tea, berries, and wine. Foods rich in these compounds have beenshown to benefit heart and brain health in the past. The problem with many earlier studies is that they’ve asked people to recall their intake of the various foods over the years, which can be unreliable, rather than randomly assigning them to eat specific foods in the present.

The participants were tested for memory and thinking skills before and after the cocoa intervention, and given a form of ultrasound that measures blood flow in the brain. There weren’t any overall differences between the high- and low-flavanol groups in terms of cognitive abilities, so the researchers looked a little deeper. They found that people who had compromised blood flow to the brain and white matter damage at the beginning of the study did show a difference after drinking the cocoa for a month: Blood flow in their brains improved by about 8%, and the time it took them to complete a working memory test dropped from 167 seconds to 116 seconds.

These results are nothing if not enticing, and they do support earlier evidence that cocoa’s benefits may stem from its capacity to improve blood flow to the brain, which uses a whopping 20% of the body’s energy, while only accounting for 2% of its weight. In other words, the brain is quite a needy organ, energetically speaking, so any improvement in blood flow could be reflected in cognition.
“We’re learning more about blood flow in the brain and its effect on thinking skills,” study author Farzaneh A. Sorond tells me. “As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer’s.”

The problem is that not only do we not know exactly how cocoa does this, but we don’t really even know what compound in it is responsible. “How cocoa results in improved neurovascular coupling, we don’t know,” says Sorond. “We also don’t know what it is in cocoa that is beneficial; is it the flavanols, the caffeine, the theobromine? In our study there was no difference between the flavanol poor and rich compounds in terms of benefit. Does this mean the flavanols are not important or does it mean that just a little bit of flavanol is enough?”

Sorond says that her hunch, based on the literature, is that it is the antioxidants – the flavanols – that are responsible. “But this has yet to be confirmed,” she adds.It’s important to point out that the big caveat in the study is that only people with compromised blood flow showed improvement, so it’s too early to recommend chocolate as a therapeutic tool to prevent or reverse cognitive decline, or to stock up on it before a big presentation or exam. The “bad” things in chocolate may effectively counteract the good ones. “I do not recommend that people add chocolate or cocoa to their diet at this point,” says Sorond. “Our results are preliminary and adding the extra calories, sugar and fat that comes with chocolate and cocoa carries additional health hazards which may offset any possible brain benefits.”

That said, an editorial in the same journal is a little more hopeful. While the authors don’t think cocoa’s effects have to do with the flavanols, they do say that in the future, “regular cocoa consumption may be a strategy to minimize (perhaps even reverse) cerebral vascular pathology
in neurodegenerative disorders, regardless of its flavanol content.”
We’ll keep watching as the cocoa studies roll in. Though there are many other places to get your flavanols, it’s likely that a little dark chocolate every now and then is not such a bad thing, and may actually be a very good one.

Wednesday, June 19, 2013

Tea and Coffee Lower Blood Pressure in Large French Registry

Michael O'Riordan
Jun 18, 2013

Blog Editors Note:  Simply put, this news release looks like a hack article meant to convince you that coffee and tea have healthy benefits.  They don't.   
Caffeine consticts the arteries.  Caffeine  doesn't do anything to heal the inflammation or clear the blockages.  Just the opposite, you will find that caffeine damages the endothelial layer of the arteries and inhibits the production of Nitric Oxide.  

Here is a real medical study for the details.  It points out that caffeine restricts the blood flow to the brain by 27%  http://www.ncbi.nlm.nih.gov/pubmed/19219847 

MILAN, Italy — A large French retrospective analysis provides good news for caffeine lovers: investigators showed that drinking tea or coffee was associated with a small but statistically significant reduction in systolic and diastolic blood pressure. In addition, drinking tea and coffee was also associated with a significant reduction in pulse pressure and heart rate, although the heart-rate reductions were greater with tea.
Presenting the results at the European Society of Hypertension (ESH) 2013 Scientific SessionsDr Bruno Pannier (Centre d'Investigations Préventives et Cliniques, Paris, France) said that other studies have suggested a relationship between coffee and tea consumption and blood pressure, but these analyses haven't been conclusive. Some have suggested a benefit, while others found no relationship between tea/coffee consumption and blood pressure.
Presenting the data on 176 437 subjects aged 16 to 95 years of age who had a checkup at their center between 2001 and 2011, Pannier explained that the analysis was simply based on a questionnaire asking participants how much coffee or tea they drank per day. Individuals were classified into three groups: those who drank no coffee/tea, those who drank one to four cups, and those who drank more than four cups.
Overall, coffee is consumed more frequently than tea, although there were differences between the sexes, said Pannier. Men were more likely to drink coffee, while women were more commonly tea drinkers. Coffee consumption was also significantly associated with tobacco consumption, higher cholesterol levels, and higher scores on stress and depression indexes. Tea consumption, on the other hand, was associated with lower cholesterol levels but similarly high scores on the stress and depression measurements.
After adjustments that included these and other potential confounding variables, both coffee and tea consumption was associated with a significant reduction in systolic and diastolic blood pressure, as well as other variables.
Blood Pressure Among Coffee Drinkers
VariableNone1 to 4 cups>4 cupsp (for trend)
Systolic blood pressure (mm Hg)127.9126.7125.5<0.0001
Diastolic blood pressure (mm Hg)
Pulse pressure (mm Hg)51.950.749.8<0.0001
Heart rate (beats/min)63.262.963.20.001
Blood Pressure Among Tea Drinkers
VariableNone1 to 4 cups>4 cupsp (for trend)
Systolic blood pressure (mm Hg)127.3126.3125.3<0.0001
Diastolic blood pressure (mm Hg)76.275.675.0<0.0001
Pulse pressure (mmHg)51.150.750.3<0.0001
Heart rate (beats/min)63.562.762.0<0.0001
Speaking during the session, Pannier explained that the group did not differentiate between green, black, or herbal tea consumption, which is one of the limitations of the analysis. In addition, the questionnaire is not sophisticated enough to address estimates in the caffeine content of the coffee consumed in France.
That said, Pannier believes that tea is a major source of flavonoids in the diet, and these compounds can improve vasodilation. "The vasorelaxing compounds included in these beverages might be involved in these results, something that has been suggested by the experimental data," he said.

Wednesday, June 5, 2013

What they found out was that when 80,000 Japanese men and women increased their intake of saturated fats, the incidence of stroke and heart attacks went down. 

Full study here.

Dietary Intake of Saturated Fatty Acids and Incident Stroke and Coronary Heart Disease in Japanese Communities

The JPHC Study

Kazumasa Yamagishi, Hiroyasu Iso, Yoshihiro Kokubo, Isao Saito, Hiroshi Yatsuya, Junko Ishihara, Manami Inoue, Shoichiro Tsugane
Eur Heart J. 2013;34(16):1225-1232. 

Abstract and Introduction


Aims Although dietary saturated fatty acids (SFA) are considered atherogenic, associations between SFAs intake and stroke and coronary heart disease are still debated. We sought to test the hypothesis that SFA intake is associated inversely with risk of stroke and its subtypes and positively with coronary heart disease among Japanese, whose average SFA intake is lower than that of Westerners.
Methods and results The Japan Public Health Center-based prospective Study involves two subcohorts: Cohort I, aged 45–64 in 1995 and followed-up through 2009, and Cohort II, aged 45–74 in 1998 and followed-up through 2007. A total of 38 084 men and 43 847 women were included in this report. Hazards ratios for incident total stroke, ischaemic stroke, intraparhenchymal haemorrhage, subarachnoid haemorrhage, myocardial infarction, and sudden cardiac death across quintiles of dietary SFAs were examined. We found inverse associations between SFA intake and total stroke [multivariable hazard ratio (95% confidence interval) for the highest vs. lowest quintiles = 0.77 (0.65–0.93), trend P = 0.002], intraparenchymal haemorrhage [0.61 (0.43–0.86), P for trend = 0.005], and ischaemic stroke [0.84 (0.67–1.06), trend P = 0.08], primarily for deep intraparenchymal haemorrhage [0.67 (0.45–0.99), P for trend = 0.04] and lacunar infarction [0.75 (0.53, 1.07), trend P = 0.02]. We also observed a positive association between SFAs intake and myocardial infarction [1.39 (0.93–2.08), trend P = 0.046] primarily among men. No associations were observed between SFAs intake and incidence of subarachnoid haemorrhage or sudden cardiac death.
Conclusions In this Japanese population, SFAs intake was inversely associated with deep intraparenchymal haemorrhage and lacunar infarction and positively associated with myocardial infarction.


Saturated fatty acid (SFA) intake has been considered to be atherogenic, and it is suggested that reducing SFA intake prevents atherosclerotic diseases.[1] Yet, recent meta-analyses have indicated that greater dietary intake of SFA per se may not be associated with increased risk of coronary disease,[2,3] though another meta-analysis showed that replacing SFA intake with polyunsaturated fatty acids (PUFA) intake was inversely associated with coronary events.[4] Several cohort studies, but not all, have reported an inverse association between dietary SFA and risk of ischaemic stroke and/or intraparenchymal haemorrhage.[3] Thus, the role of SFA intake in the development of both coronary diseases and stroke remains under debate.
Compared with Westerners, Asian people traditionally consume less SFA-containing foods, as shown in the Seven Countries Study[5] and also in later studies.[6,7] The low SFA intake among Asians has been believed to be one reason why they have lower mortality from coronary disease than Westerners. However, no prospective studies have been conducted to examine the association between dietary SFA intake and incident stroke and coronary disease in Asians, except for intraparenchymal haemorrhage.[6]

The Japan Public Health Center-based prospective (JPHC) Study is one of the largest prospective studies in Japan, with a systematic incidence registry of cardiovascular disease. An advantage of this study included enough number of population to study subtypes of stroke (i.e. subarachnoid, deep or lobar intraparenchymal haemorrhage and lacunar, large-artery occlusive or embolic infarction), which is often hard to study in Western cohorts. The population is also unique in that they have very low SFA intake and high stroke and low coronary disease incidence. Our hypotheses were that low SFA intake is associated with elevated risk of deep intraparenchymal haemorrhage and lacunar infarction, and high SFA intake with elevated risk of coronary heart disease.

Dietary Saturated Fat Has Undeserved Bad Reputation

Dietary Saturated Fat Has Undeserved Bad Reputation, Says Review

Steve Stiles
May 17, 2013
"The influence of dietary fats on serum cholesterol has been overstated," concludes a review in an American Society for Nutrition publication that, in its words, "calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs [saturated fatty acids], for which mechanisms for adverse health effects are lacking" [1].
Indeed, argues the author, Dr Glen D Lawrence (Long Island University, Brooklyn, NY), it is likely other factors, such as oxidized polyunsaturated fatty acids (PUFAs) or preservatives in processed meats, that are also present in high-SFA foods that lead to adverse health effects typically associated with high SFA intake.
"The meager effect that saturated fats have on serum cholesterol levels when modest but adequate amounts of polyunsaturated oils are included in the diet, and the lack of any clear evidence that saturated fats are promoting any of the conditions that can be attributed to PUFA, makes one wonder how saturated fats got such a bad reputation in the health literature," Lawrence writes in the review published May 1, 2013 in the journal Advances in Nutrition.
The article's case is built on interpretations of research from the biochemistry, epidemiologic, and clinical literature but which, nonetheless, does not reference a tremendous body of research supporting alternative views. Still, Lawrence describes:
  • The role of lipid peroxidation in promoting atherogenesis, arguing that its effects are more pronounced on PUFA than on SFAs or monosaturated fatty acids.
  • An arguably protective effect of omega-3 PUFAs against proinflammatory effects of omega-6 and other PUFAs.
  • Evidence that potentially carcinogenic preservatives in processed meats as well as high-heat cooking methods have influenced perceptions that red meat per se has adverse health effects.
  • How "the preparation and cooking methods used for foods that are traditionally classified as saturated fat foods may be producing substances from PUFAs and carbohydrates in those foods that are promoting disease."
  • Studies suggesting positive health effects from dairy fat and tropical oils, both high in SFAs and therefore discredited as unhealthy.
  • The hazards of diets with increased carbohydrates as a result of being lower in fat, in low-fat diets followed to improve health, especially cardiovascular health.
"The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs," the article concludes. "Consequently, the dietary recommendations to restrict saturated fats in the diet should be revised to reflect differences in handling before consumption . . . It is time to reevaluate the dietary recommendations that focus on lowering serum cholesterol and to use a more holistic approach to dietary policy."
Lawrence had no disclosures.


  1. Lawrence GD. Dietary fats and health: Dietary recommendations in the context of scientific evidence. Adv Nutr 2013; 4:294-302. 23674795

Switching from saturated fats to polyunsaturated fats demonstrates no benefits in the prevention of heart disease and death.

Switching from saturated fats to polyunsaturated fats demonstrates no benefits in the prevention of heart disease and death.  

In fact the 221 subjects who switch had a higher rate of death. 

Use of Dietary Linoleic Acid for Secondary Prevention of Coronary Heart Disease and Death

Evaluation of Recovered Data From the Sydney Diet Heart Study and Updated Meta-Analysis

Christopher E Ramsden, Daisy Zamora, Boonseng Leelarthaepin, Sharon F Majchrzak-Hong, Keturah R Faurot, Chirayath M Suchindran, Amit Ringel, John M Davis, Joseph R Hibbeln

Abstract and Introduction


Objective. To evaluate the effectiveness of replacing dietary saturated fat with omega 6 linoleic acid, for the secondary prevention of coronary heart disease and death.
Design. Evaluation of recovered data from the Sydney Diet Heart Study, a single blinded, parallel group, randomized controlled trial conducted in 1966-73; and an updated meta-analysis including these previously missing data.
Setting. Ambulatory, coronary care clinic in Sydney, Australia.
Participants. 458 men aged 30-59 years with a recent coronary event.
Interventions. Replacement of dietary saturated fats (from animal fats, common margarines, and shortenings) with omega 6 linoleic acid (from safflower oil and safflower oil polyunsaturated margarine). Controls received no specific dietary instruction or study foods. All non-dietary aspects were designed to be equivalent in both groups.
Outcome measures. All cause mortality (primary outcome), cardiovascular mortality, and mortality from coronary heart disease (secondary outcomes). We used an intention to treat, survival analysis approach to compare mortality outcomes by group.
Results. The intervention group (n=221) had higher rates of death than controls (n=237) (all cause 17.6% v 11.8%, hazard ratio 1.62 (95% confidence interval 1.00 to 2.64), P=0.05; cardiovascular disease 17.2% v 11.0%, 1.70 (1.03 to 2.80), P=0.04; coronary heart disease 16.3% v 10.1%, 1.74 (1.04 to 2.92), P=0.04). Inclusion of these recovered data in an updated meta-analysis of linoleic acid intervention trials showed non-significant trends toward increased risks of death from coronary heart disease (hazard ratio 1.33 (0.99 to 1.79); P=0.06) and cardiovascular disease (1.27 (0.98 to 1.65); P=0.07).

Conclusions. Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.