Debunking Nutrition Myths by American College of Cardiology

 

 

Dated 27th Feb 2017, the ACC (American College of Cardiology) published a review article on Debunking nutritional myths.

The article supports eating plenty of fruits, vegetables, whole grains, legumes and nuts in moderation. It also mentions that very limited quantities of lean meat, fish, low-fat and nonfat dairy products and liquid vegetable oils may be consumed. It however does not recommend intake of antioxidant pills, juicing and gluten-free diets (unless allergic to gluten).

A summary is provided:

Eggs and cholesterol:

Although a U.S. government report issued in 2015 dropped specific recommendations about upper limits for cholesterol consumption, the review concludes, “it remains prudent to advise patients to significantly limit intake of dietary cholesterol in the form of eggs or any high cholesterol foods to as little as possible.”

Vegetable oils:

According to the authors, coconut oil and palm oil should be discouraged due to limited data supporting routine use. The most heart-healthy oil is olive oil, though perhaps in moderation as it is still higher calorie, research suggests.

Berries and antioxidant supplementation:

Fruits and vegetables are the healthiest and most beneficial source of antioxidants to reduce heart disease risk, the review explains. There is no compelling evidence adding high-dose antioxidant dietary supplements benefits heart health.

Nuts:

Nuts can be part of a heart-healthy diet. But beware of consuming too many, because nuts are high in calories, said the authors.

Juicing:

The authors explain that while the fruits and vegetables contained in juices are heart-healthy, the process of juicing concentrates calories, which makes it is much easier to ingest too many. Eating whole fruits and vegetables is preferred, with juicing primarily reserved for situations when daily intake of vegetables and fruits is inadequate. If you do juice, avoid adding extra sugar by putting in honey, to minimize calories.

Gluten:

People who have celiac disease or other gluten sensitivity must avoid gluten – wheat, barley and rye. For patients who don’t have any gluten sensitivities, many of the claims for health benefits of a gluten-free diet are unsubstantiated.

 

Source: ACC Prevention Council Perspective Aims to Debunk Nutrition Myths – American College of Cardiology

Lets help the underprivileged kids.

Apni Shala.png

Dear Friends,
I have been running half-marathons for last 7 years. But this is the second time I am running the SCMM (Mumbai) 2017 for a cause. I am supporting an organization called Apni Shala which imparts life skills to underprivileged kids in Mumbai (Dharavi and Kurla). I have volunteered to raise funds for the organisation and would request you to support it wholeheartedly.
Below is the link to my Fundraising page through which donations can be done and are eligible for 80G tax exemption.
https://www.unitedwaymumbai.org/scmm-fundraiser-7091
Please go through their website to know more about their work.
http://www.apnishala.org
I Hope to receive your full-fledged support. Thanks!
Ameya Udyavar

apni-shala-2

Slow Down! Life is not a race!

Todays life is fast paced!

Everyone wants everything fast: Meals delivered at a click of a button! Things delivered within minutes. A rush to reach their destinations within seconds. No patience to wait in queues. Everything at a click of a button. Even meals are cooked fast. Even expect our kids to grow up fast and achieve more in a short time. Surfing channel to see whats being played in different channels at the same time. No time to stand in grocery queues.

However, nature does not want us to live our lives so fast paced..

Living fast paced can give rise to anxiety, high blood pressure and stress.

It wants us to slow down!

Enjoy the things around us!

Even in cities there is so much of nature around us.

We should be watching the sunrise through our windows.

Listen to the birds chirping and the wind blowing.

Listen to the dogs barking.

Listen to the rain drops falling on a tin roof.

Enjoying our morning cuppa of coffee at an leisurely pace.

Enjoying its aroma.

Strolling leisurely in a park.

Not be bound by time.

Read the hard copy of “A Book of Simple Living: Brief Notes from the Hills” by Ruskin Bond!

Cooking a slow meal and enjoying the process of cooking the meal.

Eating leisurely with kids and family.

Lazing on a sofa with your favourite novel.

Going for a slow jog without attention to timing or pace.

Practising mindfulness in our lives!

Keeping our electronic gadgets shut for a day!

What a life that would be.

It would add Chi to our daily lives.

So SLOW DOWN!

Make your day pleasant!

 

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Sugar, Sugar, Sugar, Which is the sweetest dessert of them all!

We all love desserts! They give us a feeling of satiety and satisfaction which few things in this world provide. However, too much of indulgence can be harmful. Its better to be informed and make a choice about the dessert depending on its sugar content.

 

Here is a chart from Shari’s Berries showing the sugar content of different desserts.

 

As Julissa from Shari’s Berries mentions “Although most say “There is ALWAYS room for dessert”, there is no reason to go overboard on your sugar taste buds especially if you are watching your weight or want something lighter.

That’s why Shari’s Berries has created a visual chart with the most popular desserts you find at restaurants and parties. The desserts range from lowest to highest in sugar content, hopefully making your choice a little bit easier. Sweets are definitely fun but moderation is key!”

 

sweetest-desserts

http://www.berries.com/blog/sweetest-desserts

 

should we trust and follow evidence based guidelines?

Guidelines authored by Medical bodies like American Heart Association are strongly followed in our cardiology practise in India as there is lack of trial data conducted in India. I as a practising cardiologist strongly advocate Guideline based therapy. 

However, lately I have been surprised by the recommendations of the new guidelines on various topics. This is because of the change in recommendations which are totally contrary to the previous version of the guidelines. 

Let me cite some examples:

  1. The ATP-3 guidelines strongly advocated Goal based therapy for LDL-cholesterol management. They suggested that LDL cholesterol should be maintained below 100 mg/dl in patients with diabetes  or coronary artery disease. These recommendations were followed by Cardiologists all over the world for the last 12-13 years. However, the new guidelines on Lipid management released by the ACC 2014 mentions that there is no trial to suggest that the target-based therapy of LDL cholesterol works. Instead they advocate high dose statin to be given in patients with high risks and to bring down the LDL cholesterol levels by 50%. This is a drastic change which then calls into question the data on which the earlier ATP guidelines were based.

2.  Beta-blockers were advocated in earlier version of guidelines for treatment of Vasovagal syncope. Even, in my personal experience I have number of patients who felt better with beta-blockers and had remission in their symptoms. However, the new guidelines mentions beta-blockers as Class III (harmful).

3. Amiodarone was advocated earlier for acute treatment of  recurrent ventricular tachycardia (VT). However the new European guidelines on Arrhythmias in ACS mentions that it should be avoided and instead Cardioversion should be preferred.

 

The drastic change in the new recommendations/ guidelines  for treatment of the various disorders (as mentioned above in examples) is unexpected and surprising. The reasons for these may be availability of new trial data or not a thorough evaluation of the trials by earlier committees.

Whatever the reasons, for us as practising Clinicians, patient safety is paramount. Thus, Strict adherence to the new guidelines is advisable and to be followed (till the time we have data available from trials conducted in India on Indian patients). However the therapy should be discussed with and individualised for each patient.

 

 

Leisure Jogging Associated With Lowest Mortality Risk!

 

The optimal frequency of jogging in terms of mortality risk was shown to be two to three times a week and at a leisurely pace, according to a study published Feb. 2 in the Journal of the American College of Cardiology (JACC). Jogging three times or more a week was not shown to be statistically different from remaining sedentary.

 

Using data from the Copenhagen City Heart Study, researchers observed the pace, quality and frequency of jogging in 1,098 healthy joggers and 3,950 healthy non-joggers to evaluate the association between jogging and long-term, all-cause mortality. Participants were excluded for a history of coronary heart disease (CHD), stroke and cancer. Participants rated their physical activity on a graded scale of one to four: one, almost entirely sedentary; two: light physical activity 2-4 hours per week; three: vigorous activity for 2-4 hours per week, or light physical activity for more than four hours per week; four: high vigorous physical activity for more than four hours. Joggers were further divided into three subgroups based on dose of jogging: slow (5 mph, 7 mph, >4 hours per week, >3 times per week).

Follow-up of all participants occurred from their first examination in 2001 until 2013, or death (a 12 year followup!).

The results of the study showed that jogging from 1 to 2.4 hours per week was associated with the lowest mortality, while greater quantities of jogging were not significantly different from remaining sedentary in terms of mortality risk. Further, researchers found a U-shaped association between jogging and mortality. Researchers reported 28 deaths among joggers and 128 among sedentary non-joggers, though no causes were recorded.

The authors conclude that “the U-shaped association suggests the existence of an upper limit for exercise dosing that is optimal for health benefits…If the goal is to decrease the risk of death and improve life expectancy, going for a leisurely job a few times per week at a moderate pace is a good strategy.”

In an accompanying editorial comment, Duck-chul Lee, PhD, Department of Kinesiology, College of Human Sciences, Iowa State University, adds that the study “adds to the current body of evidence on the dose-response relationship between running and mortality. However, further exploration is clearly warranted regarding whether there is an optimal amount of running for mortality benefits, especially for cardiovascular and CHD mortality. In addition, because self-reported doses of running may induce measurement error and bias, it would be preferable to use an objective assessment of doses of running in future studies.”

Valentin Fuster, MD, PhD, MACC, editor-in-chief of JACC, remarks that “this study attempts to answer the question about whether increased intensity among better trained individuals results in improved outcomes. What is most interesting in this paper is the U-shaped curve of the findings, indicating that moderate exercise, with regard to total duration, frequency and intensity, results in the best benefit. Thus, it was fascinating to see that both the sedentary population and the aggressive exercisers (with regard to frequency, duration and speed) have higher mortality rates than the moderate exercisers.”

 

So, slow down a little if you are jogging too fast and too much! Soak in the surrounding and enjoy the jog at a leisurely pace!

 

 

via Study Shows Leisure Jogging Associated With Lowest Mortality Risk | ACC News Story – American College of Cardiology.