Diet habits in patients with normal coronary arteries and with coronary artery disease.
Abstract:
Introduction: Evidence shows that bad diet habits have been linked to the development of obesity, diabetes, and dyslipidemia . This study evaluates diet habits among patients with coronary artery disease and patients without CHD.
Method: 301 consecutive patients were entered the study, these patients had scheduled for elective coronary angiography by two cardiologists. After verbal consent, they were asked to fill up a questionnaire about their diet habits, just before coronary angiography by a registered nurse.
Result: The mean patients' age was 60.1±10.57 years. (40.0 to 87.0 years old). Average body mass index (BMI) was 26.42±3.39 (18.46-40.05).There is statistically significant difference between BMI, total cholesterol, TG, FBS, smoking in two groups of patients. (Normal and disease coronary), There is also statically significant different in heavy sugar-sweetened (Soda) beverage intake, vegetable fat, juice and tea consumption in normal and diseased coronary angiography.
Conclusion: This article highlights harmful effects of bad eating habits like as heavy consumption of sweetened beverage on cardiovascular health. A large cohort could be considered to better assess the exact role of some foods in our health.
Keywords:
Diet habits
Coronary angiography
Coronary artery disease
Evidence shows that bad diet habits have been linked to the development of obesity, diabetes, and dyslipidemia .For example sugar sweetened drinks could cause insulin resistance, increased total and visceral fat mass, and accumulation of ectopic fat in the liver and skeletal muscle which in the long term, will cause the development of the metabolic syndrome. The risk of cardiovascular mortality increases dramatically as sugar intake increases, peaking with a fourfold increased risk of CVD death for individuals who consume one-third or more of their daily calories in added sugar. (1)Several cross-sectional studies have shown that increased soft drink intake is related to lower consumption of milk and calcium, and higher intake of carbohydrates, lower intakes of fruit and dietary fiber and lower intakes of a variety of macronutrients . A meta-analysis suggests that sugar sweetened beverages may increase risk of coronary heart disease (CHD), especially among men. (2)
This study evaluates diet habits among patients with coronary artery disease and patients without CHD.
Methods
301 consecutive patients were entered the study, these patients had scheduled for elective coronary angiography by two cardiologists. All patients classified as stable coronary artery disease and they had indication for coronary angiography according to ACC/AHA guidelines.(1) After verbal consent their blood pressure, height and weight was measured and they were asked to fill up a questionnaire about their diet habits, just before coronary angiography by a registered nurse. Venous blood sample for total cholesterol, LDL, FBS, HDL, creatinine was withdrawn before angiography. Angiography has been reviewed by two cardiologists and coronary artery disease was present if there is more than 50% stenosis of one of the coronary arteries. Heavy consumption was defined as more than six unit consumption per day .Values are given as mean ± SD. Statistical analysis was done using the SPSS version 17.0 (Chicago, IL, USA) and a difference was considered significant at P<0.05.Data were compared by using Kruskal–Wallis statistical method.
Results
301 patients who were candidate of coronary angiography enrolled in this study. Patients divided to four groups: normal coronary Artery, (NCA), single vessel diseased (SVD), two vessel diseased (2VD) and three vessel disease (3VD). The mean patients' age was 60.1±10.57 years. (40.0 to 87.0 years old). Average body mass index (BMI) was 26.42±3.39 (18.46-40.05).There is statistically significant difference between BMI, total cholesterol, TG, FBS, smoking in two groups of patients. (Normal and disease coronary), Table one outlines diet habits of study population. Table 2,3 show demographic characteristics of study population and table 4 outlines correlation between heavy consumption of different food and coronary artery disease.
Table one: Diet habits of study population.
No consumption / Low consumption3day / Intermediate3≤Consumption6/day / heavy consumption≥6/day
number / percent / number / percent / number / percent / number / percent
tea / 29 / 6/9 / 23 / 6/7 / 63 / 9/20 / 186 / 8/61
Sweetened beverage / 13 / 3/4 / 88 / 2/29 / 120 / 9/39 / 80 / 6/26
Ayran / 29 / 6/9 / 124 / 2/41 / 123 / 9/40 / 25 / 3/8
juice / 66 / 9/21 / 155 / 5/51 / 69 / 9/22 / 11 / 7/3
milk / 58 / 3/19 / 104 / 6/34 / 108 / 9/35 / 31 / 3/10
Fast food / 241 / 1/80 / 57 / 9/18 / 0 / 0/0 / 3 / 0/1
Red meat / 25 / 3/8 / 192 / 8/63 / 58 / 3/19 / 26 / 6/8
fish / 168 / 8/55 / 123 / 9/40 / 7 / 3/2 / 2 / 7/0
Vegetable oil / 143 / 5/47 / 11 / 7/3 / 9 / 0/3 / 138 / 8/45
Hydrogenated oil / 137 / 5/45 / 16 / 3/5 / 5 / 7/1 / 143 / 5/47
Animal fat / 246 / 7/81 / 31 / 3/10 / 0 / 0/0 / 24 / 0/8
Table2: demographic characteristics of study population.
patients / P valuemean±SD / Minimum / Maximum
BMI / 39/3 ± 42/26 / 46/18 / 05/40 / 001/0>P
Total cholestrol / 439/45 ± 68/197 / 19 / 300 / 001/0>P
Triglyceride / 80/77 ± 93/165 / 16 / 426 / 001/0>P
LDL / 157/31 ± 70/116 / 56 / 195 / 001/0>P
HDL / 85/6 ± 31/36 / 20 / 63
FBS / 38/33 ± 87/114 / 100 / 262 / 001/0>P
Systolic blood pressure / 59/12 ± 76/132 / 145 / 185 / 001/0>P
Diastolic blood pressure / 91/6 ± 19/83 / 70 / 100 / 001/0>P
Table3; demographic characteristics of patients with respect to coronary artery disease
M/F / 0.8 / 0.9 / 1.3 / 2.1 / 0.03smoker / 34% / 45.5% / 47.1% / 0.003
age / 73/11±82/59 / 31/10±58/61 / 0/10±08/59 / 78/8±58/60 / 504/0
BMI / 71/2±76/24 / 40/3±37/27 / 56/3±07/27 / 91/2±94/27 / 001/0>
Table4: correlation between heavy consumption of different food and coronary artery disease.
normal group / SVD / 2VD / 3VD / P valueHeavy salt consumption / 32.1% / 54.5 / 58.8 / 61% / 0.003
Heavy Tea consumption / 46.8% / 71.2%, / 68.2%, / 73.2% / 0.001
Heavy Yoghurt consumption / 56% / 53 / 42,4 / 31.7% / 0.348
Heavy milk consumption / 15.6%, / 3% / 4.7% / 19.5% / P<0.001
Heavy Fast food / 1.8 / .1.5 / 0 / 5% / P=0.098
Red Meat heavy consumption / 5.5 / 10.6 / 9.4 / 12.2% / P=0.009
Fish heavy consumption / 0.9 / 0.102 / 5% / (0/0)0 / P=0.108
Vegetable oils / 69.7 / 33.3 / 34.1 / 26.8% / p<0.001
Animal fat consumption / 4.6 / 9.1 / 5.9 / 19.5 / P= 0.096
Heavy sugar-sweetened beverage intake / (0/11)12 / (3/30)20 / (0/40)34 / (1/34)14 / 001/0>
As shown in table4 there is statically significant different in heavy sugar-sweetened (Soda) beverage intake, vegetable fat, juice and tea consumption in normal and diseased coronary angiography.
Discussion:
Diet habits are very important in terms of both primary and secondary prevention of coronary artery disease. In this article we compared the outcome of these habits in a small community of stable angina patients. As mentioned in the result section, patients with CAD consume more sweetened drink than normal coronary patients. It is in concordance with other perspective studies. (3, 4)
Animal fat intake is another bad diet habit in our culture; however in our study there is no statistical difference between two groups of our patients (normal and diseased coronary patients) but 3VD patients are heavy consumer of animal fat in contrast with vegetable oil consumers who are more prevalent in normal group.
Like as other studies, in our study red meat consumption did not link to coronary artery disease. (5)
In contrast to previous studies there is no statistical significant difference between heavy Fish consumption and other groups. We think it is because of the most consumed fish in our geographical area is rainbow trout and it is not a good source of omega3.(6)
In our study heavy black tea consumers are more prevalent in 3VD patients. Beside heavy metal contamination in some brands of tea, which has a detrimental effect on cardiovascular health (7) there is no definite evidence about protective or harmful role of black tea.(8)
There is also controversial idea about dairy product intake and risk of coronary artery disease. In a study published on 2013 there is no evidence that dairy products are associated with risk of CHD or stroke. (9) However in our study SVD and 2VD patients consumes less milk than 3VD and normal patients, it does not proof that milk has any protective role in CAD.
To sum up, this article highlights harmful effects of bad eating habits like as heavy consumption of sweetened beverage on cardiovascular health. A large cohort could be considered to better assess the exact role of some foods in our health.
References:
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2-Massimo Collino,High dietary fructose intake: Sweet or bitter life?World J Diabetes. 2011; 2(6): 77–81.
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