Around the holidays, "have a heart" is a common plea by those collecting for charities, but year round we all strive to have a healthy heart.
Coronary heart disease (CHD) is the leading cause of death in the U.S., and heart attacks cause one of every five adult deaths, according to the American Heart Assn. More than 1.2 million heart attacks occur each year in the U.S. alone, and about 460,000 of them are fatal, notes the National Institutes of Health. In fact, coronary heart disease accounts for about 17 million (approximately 30 percent) deaths annually throughout the world, making it the leading cause of death in the world, according to the World Health Organization.
Based on those frightening statistics, the market for foods with a heart benefit claim is proliferating. In France, Germany, Italy, Spain and the UK, the heart-healthy food market was valued at $2.61 billion in 2009 by UK-based Leatherhead Food Research. The U.S. market for foods making cardiovascular health claims was $7.18 billion, reflecting the use of FDA-approved structure-function claims for whole grains, soy and beta glucan-delivering oats.
Although physicians worldwide agree smoking, lack of exercise, stress, excess weight and family history are the most important contributors to heart disease, doctors and nutritionists do not always agree on the role of food. Current wisdom says eating a low-cholesterol, low-fat diet is the best dietary option, but it gets complicated after that, sometimes downright contentious.
Last year, researchers at Population Health Research Institute, Hamilton Health Sciences and the Departments of Medicine and Clinical Epidemiology and Biostatistics at McMaster University, Hamilton, Ontario, analyzed 189 prior studies involving millions of people and foods that may protect the heart from CHD. The findings, which appeared in the Archives of Internal Medicine (April issue), include a relatively short list of foods with strong supporting evidence: vegetables, nuts and the Mediterranean diet. Harmful factors were foods with trans-fatty acids and those with a high glycemic index or load. Moderate positive evidence was found for fish, marine omega-3 fatty acids, folate, whole grains, dietary vitamins E and C, beta-carotene, alcohol, fruit and fiber. It is notable the study did not analyze specific combinations of those nutrients in foods, something the food industry is pursuing in heart-healthy- and wellness-targeted foods and beverages.
The Mediterranean diet is rich in vegetables and fruit (it recommends nine servings a day), nuts, whole grains, fish, olive oil and moderate consumption of red meat and wine. It's associated with lower levels of oxidized low-density lipoprotein, or bad cholesterol, which is likely to build up deposits in arteries that lead to heart attacks. Fortunately for foodies, the diet does not prohibit other foods eaten in moderation (and that probably relieves some stress).
"Almonds deliver deliciously on heart health and consumers know it," says Stacey Humble, director of global strategic initiatives and North America marketing for the Almond Board of California. "No fewer than nine clinical studies to date indicate almonds can help you maintain a healthy cholesterol level as part of a diet low in saturated fat. Even the FDA states, 'Scientific evidence suggests, but does not prove, that eating 1.5 oz per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.' "
U.S. health claims
There are five FDA-accepted label claims directly related to heart disease, involving:
- Fruits, vegetables and grain products that contain fiber, particularly soluble fiber.
- Soluble fiber from [other] foods.
- Soy protein.
- Plant sterol/stanol esters.
- Diets low in saturated fat and cholesterol, and as low as possible in trans fats.
And two more (sodium and potassium) relating to hypertension.
Plus, there are four qualified health claims ("Scientific evidence suggests but does not prove…") involving: