Although a healthy diet and a good exercise regime may seem the obvious ways of reducing one's risks for cardiovascular events, such as myocardial infarction and heart failure, no prior research has investigated the benefit achieved with a combination of several healthy lifestyle behaviors on coronary heart disease (CHD). Findings from a new Swedish study by Dr. Agneta Akesson and colleagues indicate, that the combined benefit of diet, physical activity, nonsmoking and healthy body weight could prevent as much as three out of every four cases of myocardial infarctions (MI) in women.

Heart disease is the leading cause of death worldwide. Although CHD remains more common among men, mortality and the percentage of sudden deaths related to CHD without previous symptoms are higher among women. Although lifestyle and dietary changes have been demonstrated to reduce the clinical effect of CHD, it remains unclear how these alter the risk for heart disease.

A 2007 research of 24,444 postmenopausal women with no previous history of ischemic heart disease, cardiovascular disease or cancer defined low-risk factors for MI as:

• healthy diet, focused on vegetables, fruits, and legumes, moderate alcohol consumption (5 g or more a day, equivalent to a glass of wine every other day)
• exercise consisting of at least 40 minutes per day of walking or cycling and 1 hour per week devoted to exercise exclusively
• waist-to-hip ratio of less than 0.85 (which reflects low abdominal adiposity)
• nonsmoking.

Among women who did not smoke, had high levels of physical activity and low abdominal adiposity, risk of myocardial infarctions was reduced by 79% compared with women in the highest risk group. In other words; more than 3 out of 4 coronary events reported during the study could have been prevented if all women had changed their lifestyle to the low-risk profile. Moreover, the 5% of the study population who fulfilled all five low-risk lifestyle factors, had a 92% decreased risk of myocardial infarction compared with women without any low-risk diet and lifestyle factors.

Despite the proven benefits of pharmacologic therapies, research has shown diet and lifestyle have great influence on morbidity and mortality in CHD. Results demonstrate that important steps can be taken to significantly reduce the risk of primary nonfatal CHD, and what's more, you can do them by yourself.

A second research, conducted on 21,376 men, was focused on the relationship between whole-grain cereals and incidence of heart failure (HF). Higher intake of whole-grain cereals (but not refined) appeared to reduce the risk for HF. Most likely the beneficial effects of whole grains on reducing heart failure are mediated via their effects on blood pressure and lowering the risk of diabetes and coronary heart disease.

However, effects of the study might have been exaggerated as it was performed in a highly educated group of mainly white men (physicians), with knowledge about the disease, rather than on a randomized group of men. Results need to be replicated in general population, including women, people of ethnic minorities and those without knowledge of heart disease. In the meantime, there is no harm in switching to whole-grain (i.e. not regular) cereals, pasta and bread and adding a few more tomatoes and cucumbers to you diet.

Source: Healthy Diet and Lifestyle Cut MI Risk, Heart Failure (Medscape)