CHOICE

TALK TO YOUR DOCTOR

Reference Riedl, David, and Gerhard Schüßler. “The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review.” Zeitschrift für Psychosomatische Medizin und Psychotherapie 63, no. 2 (2017): 131-150.

Research Summary Researchers from Medical University of Innsbruck, Austria systematically reviewed 17 controlled studies and eight qualitative studies on the influence of the doctor-patient relationship and communication on health outcomes, retrieved by a search of the medical literature from 2000-2015. The statistical analysis showed that building a doctor-patient relationship had a positive effect on gathering health information and patient education in 60% of the studies. Communication skills showed improved results and enabled treatment-related emotions and behavior. Although more studies will be necessary, this systematic review revealed different domains of the doctor-patient relationship and communication positively influenced different objective (e.g. blood pressure) and subjective (e.g. pain scores) health outcomes.

COMMIT TO A HEALTHY LIFESTYLE

Reference Adriaanse, Marieke A., Charlotte DW Vinkers, Denise TD De Ridder, Joop J. Hox, and John BF De Wit. “Do implementation intentions help to eat a healthy diet? A systematic review and meta-analysis of the empirical evidence.” Appetite 56, no. 1 (2011): 183-193.

Research Summary Researchers from Utrecht University, Netherlands conducted a systematic review to examine whether setting intentions for implementation is an effective tool for developing healthy diet habits. A total of 23 empirical studies investigating the effect of intentions on the implementation of eating behavior were included. In assessing the data, a distinction was made between studies that aim to increase healthy eating (e.g. eating more fruits) and studies that aim to diminish unhealthy eating (e.g. eating fewer unhealthy snacks). The meta-analysis showed that intentions for implementing was an effective tool for promoting the inclusion of healthy food items in one’s diet. Results for replacing unhealthy eating patterns were less strong.

CHOOSE TO STOP

Reference Yang, Yue-Nin, Yu-Tung Huang, and Chun-Yuh Yang. “Effects of a national smoking ban on hospital admissions for cardiovascular diseases: a time-series analysis in Taiwan.” Journal of Toxicology and Environmental Health, Part A 80, no. 10-12 (2017): 562-568.

Research Summary Researchers from Kaohsiung Medical University, Taiwan studied the association between a comprehensive smoking ban (January 11, 2009), implemented in Taiwan, to evaluate hospital admissions for ischemic heart disease (IHD). Trends in the country-level monthly hospital admission rates for IHD were determined and frequency was compared to other conditions such as cholecystitis, bowel obstruction, and appendicitis from January 1997 (one year before the first phase of smoke-free laws was implemented) to December 2012 (three years after the second phase of the ban). Statistical analysis showed that hospital admission rates for IHD decreased by eight percent compared to those prior to the pre-ban period. This decrease was significant for both men and women and for all age categories after both first and second phases of the ban.

Reference Huang, Xingtao, Xuedong Wang, Yongpeng Zou, Shuyuan Chen, Ruoxi Zhang, Lulu Li, Bo Yu, and Jingbo Hou. “Impact of Cigarette Smoking and Smoking Cessation on Stent Changes as Determined by Optical Coherence Tomography After Sirolimus Stent Implantation.” The American Journal of Cardiology 120, no. 8 (2017): 1279-1284.

Research Summary Researchers from The Second Affiliated Hospital of Harbin Medical University, China evaluated the microstructural changes after stenting in patients with different smoking statuses. One-hundred and seventy-nine patients underwent an optical coherence tomography examination twelve months after stenting. Participants were classified as current smokers, smoking cessation equal to and less than one-year, smoking cessation equal to and greater than one year, and never smokers. Results showed continued smoking increased the thickening of arterial walls and the incidence of misaligned struts. Smoking cessation slowed down thickening of arterial wall progression and decreased the incidence of misaligned struts. The authors concluded that smoking cessation promotes vascular healing.

STRESS LESS

Reference Chandola, Tarani, Annie Britton, Eric Brunner, Harry Hemingway, Marek Malik, Meena Kumari, Ellena Badrick, Mika Kivimaki, and Michael Marmot. “Work stress and coronary heart disease: what are the mechanisms?” European Heart Journal 29, no. 5 (2008): 640-648.

Research Summary Researchers from University College London and St George’s University of London studied (Whitehall Study) over 10,000 London-based civil servants (ages 35-55) to examine the association between exposure to work stress and development of cardiovascular disease (CHD), and health behaviors, over a 20-year period. Chronic work stress was associated with CHD and this association was stronger among participants under 50 years of age. There were similar associations between work stress and low physical activity, poor diet, metabolic syndrome, and lower heart rate variability. Work stress was also associated with a higher morning rise in cortisol. Around 32% of the effect of work stress on CHD was attributable to its influence on developing unhealthy behaviors (e.g. smoking) and the metabolic syndrome. The authors concluded that work stress may be an important determinant of CHD among working-age populations.

MAINTAIN A HEALTHY BLOOD PRESSURE

Reference Levy, Daniel, Martin G. Larson, Ramachandran S. Vasan, William B. Kannel, and Kalon KL Ho. “The progression from hypertension to congestive heart failure.” Jama 275, no. 20 (1996): 1557-1562.

Research Summary Researcher from the Framingham Heart Study (a long-term cardiovascular medical study on residents of the residents of the town of Framingham, Massachusetts. The study (began in 1948 with over 5,000 adults, and is now on its third generation), statistically analyzed three measures: 1) hypertension as a risk for the development of congestive heart failure (CHF); 2) time of progression from hypertension to CHF; 3) risk factors that contribute to the development of heart failure in patients with hypertension. Hypertension (blood pressure of at 140 Hg systolic or 90 mm Hg diastolic or current use of medication for treatment of high blood pressure) and other potential CHF risk factors were assessed at periodic clinic examinations. A total of 5,143 eligible subjects were examined over a twenty-year period. Statistical analysis revealed that hypertension was a high-risk factor for developing heart failure, accounting for 39% in men and 59% in women. Survival following the onset of hypertensive CHF was bleak; only 24% of men and 31%of women survived five years after developing.

REST

GET MORE SLEEP

Reference Liu, Tong-Zu, Chang Xu, Matteo Rota, Hui Cai, Chao Zhang, Ming-Jun Shi, Rui-Xia Yuan et al. “Sleep duration and risk of all-cause mortality: a flexible, non-linear, meta-regression of 40 prospective cohort studies.” Sleep medicine reviews 32 (2017): 28-36.

Research Summary Researchers from 11 universities in the United States, China, Italy, and France conducted a systematic review of 40 medical studies, enrolling over two million participants, on the association of sleep duration and death heart disease and other conditions, retrieved by published medical literature through November 2015. Results showed that both shortened sleep (less than four hours) and prolonged sleep (greater than 8 hours) were linked to increased risk for death from heart disease and other conditions in adults when compared with seven hours of sleep. The current evidence suggests that insufficient or prolonged sleep may increase death from heart disease and other conditions.

Reference Wang, Dongming, Wenzhen Li, Xiuqing Cui, Yidi Meng, Min Zhou, Lili Xiao, Jixuan Ma, Guilin Yi, and Weihong Chen. “Sleep duration and risk of coronary heart disease: A systematic review and meta-analysis of prospective cohort studies.” International journal of cardiology 219 (2016): 231-239.

Research Summary Researchers from Tongji Medical College, China systematically reviewed 17 articles with 22 independent reports involving over half a million participants, on the association of sleep duration and risk of coronary heart disease, retrieved from the medical literature through January 2016. Both short and long sleep durations are significantly associated with increased risk of coronary heart disease. Compared with seven-hour sleep duration per day, the risk of coronary heart disease increased 11% for an hour decrease and increased seven percent for an hour increase.

FIGHT INSOMNIA

Reference Tan, Xiao, Markku Alén, Shu Mei Cheng, Tuija M. Mikkola, Jarkko Tenhunen, Arja Lyytikäinen, Petri Wiklund et al. “Associations of disordered sleep with body fat distribution, physical activity and diet among overweight middle‐aged men.” Journal of sleep research 24, no. 4 (2015): 414-424.

Research Summary Researchers from six universities in Finland and China studied the association between body fat distribution, physical activity levels, dietary intakes, and insomnia and/or obstructive sleep apnea among overweight, middle-aged men. Participants were 211 Finnish men, ages 30-65. Among the 163 overweight or obese participants, 40 had insomnia only, 23 had obstructive sleep apnea only, 24 had multiple causes of insomnia and obstructive sleep apnea, and 76 were without sleep disorder. The remaining 48 participants had normal weight without sleep disorder. Fat mass was measured and levels of physical activity were determined by questionnaire and dietary habits by a three-day food diary. Results suggested that abdominal obesity is associated with insomnia and/or obstructive sleep apnea. In addition, low levels of leisure-time physical activity and poor dietary intakes are related to insomnia and obstructive sleep apnea among overweight men.

CHECK IT OUT

Reference Hein, Matthieu, Jean-Pol Lanquart, Gwénolé Loas, Philippe Hubain, and Paul Linkowski. “Prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in insomnia sufferers: a study on 1311 subjects.” Respiratory research 18, no. 1 (2017): 135.

Research Summary Researchers from Université Libre de Bruxelles, Belgium analyzed data from 1,311 insomnia sufferers recruited from the research database of the sleep laboratory of the Erasme Hospital to examine the prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome. An apnea-hypopnea index of equal to or greater than 15 events per hour was used as the cut-off score for moderate to severe obstructive sleep apnea syndrome. Results showed a fourteen percent prevalence of moderate to severe obstructive sleep apnea syndrome in the sample of insomnia sufferers. Male gender, snoring, excessive daytime sleepiness, and presence of metabolic syndrome were significant.

TAKE DAILY BREAKS

Reference Hunter, Emily M., and Cindy Wu. “Give me a better break: Choosing workday break activities to maximize resource recovery.” Journal of Applied Psychology 101, no. 2 (2016): 302.

Research Summary Researchers from Baylor University, United States examined the association between workday break characteristics and well-being, in 95 employees, observed over five workdays. Results indicated that activities that were chosen by the employee and chosen earlier in the work shift related to more recovery following the break. In addition, break length interacted with the number of breaks per day such that longer breaks and frequent short breaks were associated with more recovery than infrequent short breaks.

Reference Kühnel, Jana, Hannes Zacher, Jessica De Bloom, and Ronald Bledow. “Take a break! Benefits of sleep and short breaks for daily work engagement.” European Journal of Work and Organizational Psychology 26, no. 4 (2017): 481-491.

Research Summary Multi-institutional researchers from Finland, Germany, and Singapore, investigated the benefits of a good night’s sleep and short work breaks for employees’ daily work engagement. It was hypothesized that sleep and self-initiated short breaks help restore energy which, in turn, enable employees to experience high work engagement. A daily diary study was conducted with 107 employees who provided data twice a day (before lunch and at the end of the working day) over five workdays (453 days in total). Statistical analysis showed that sleep quality and short breaks were beneficial for employees’ daily work engagement. After nights when employees slept better, they indicated higher work engagement during the day. Moreover, taking self-initiated short breaks from work in the afternoon boosted daily work engagement.

GO ON VACATION

Reference Gump, Brooks B., and Karen A. Matthews. “Are vacations good for your health? The 9-year mortality experience after the multiple risk factor intervention trial.” Psychosomatic Medicine 62, no. 5 (2000): 608-612.

Research Summary Researchers from State University of New York, United States studied the risk for various causes of death associated with vacation frequency during the Multiple Risk Factor Intervention Trial (MRFIT). Over 12,000 middle-aged men at high risk for coronary heart disease (CHD) were recruited for the MRFIT. As part of the questionnaires administered during the first five annual visits, men were asked whether they had had a vacation during the past year. Statistical analysis showed the frequency of annual vacations by middle-aged men at high risk for CHD is associated with a reduced risk of all-medical cause death and, more specifically, death attributed to CHD.

ENVIRONMENT

LET THE SUNSHINE IN

Reference Aleksova, Aneta, Rita Belfiore, Cosimo Carriere, Salam Kassem, Salvatore La Carrubba, Giulia Barbati, and Gianfranco Sinagra. “Vitamin D deficiency in patients with acute myocardial infarction: an Italian single-center study.” Int J Vitam Nutr Res 85, no. 1-2 (2015): 23-30.

Research Summary Researchers from University of Trieste, Italy studied the vitamin D status in four hundred and seventy-eight participants diagnosed with acute myocardial infarction (AMI). Results showed that vitamin D deficiency in sixty-eight percent, and insufficiency in twenty-two percent of the participants. The researchers reported a very high prevalence of vitamin D deficiency among subjects with AMI in all seasons of enrollment. The authors concluded that exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D.

CUT THE CLUTTER

Reference Roster, Catherine A., Joseph R. Ferrari, and M. Peter Jurkat. “The dark side of home: Assessing possession ‘clutter’ on subjective well-being.” Journal of Environmental Psychology 46 (2016): 32-41.

Research Summary Researchers from University of New Mexico and DePaul University, United States investigated the experienced quality of home when compromised by clutter, defined as an overabundance of possessions that collectively create chaotic and disorderly living spaces. An online survey was conducted with a population of U.S. and Canadian adults. Findings reveal that clutter had a negative impact on psychological experience of home and a sense of well-being. The authors concluded that these findings contribute to a broader understanding of how meanings of home are undermined by individuals’ clutter-making efforts.

SURROUND YOURSELF WITH GREEN

Reference Gascon, Mireia, Margarita Triguero-Mas, David Martínez, Payam Dadvand, David Rojas-Rueda, Antoni Plasència, and Mark J. Nieuwenhuijsen. “Residential green spaces and mortality: a systematic review.” Environment international 86 (2016): 60-67.

Research Summary Researchers from Universitat Pompeu Fabra, Spain conducted a systematic review exploring the relationship between long-term exposure to residential green and blue spaces and the risk death in adults. The review identified 12 eligible studies conducted in North America, Europe, and Oceania with study populations ranging from 1,645 up to more than 43 million individuals. The statistical analysis indicated that the majority of studies showed a reduction of the risk of death from cardiovascular disease (CVD) in areas with higher residential greenness. Although more studies will be necessary for more complete evidence, this review indicated that living in areas with higher amounts of green spaces reduces chances of death, mainly from CVD.

Reference Triguero-Mas, Margarita, David Donaire-Gonzalez, Edmund Seto, Antònia Valentín, David Martínez, Graham Smith, Gemma Hurst et al. “Natural outdoor environments and mental health: Stress as a possible mechanism.” Environmental Research 159 (2017): 629-638.

Research Summary Researchers representing 27 institutions from Spain, United Kingdom, Netherlands, and Lithuania explored the relationship between exposure to natural outdoor environments (NOE) and various indicators of mental health. Analysis of data from 406 participants level of exposure to NOE (including both surrounding greenness and green and/or blue spaces) were measured over a seven-day period. Self-reported information was collected for mental health psychological well-being, sleep quality, vitality, perceived stress, and social contacts. Results showed exposure to natural outdoor environments, especially surrounding greenness, was statistically significantly tied to better mental health and lower stress.

BREATHE EASY

Reference Khaniabadi, Yusef Omidi, Seyed Mohammad Daryanoosh, Philip K. Hopke, Margherita Ferrante, Alessandra De Marco, Pierre Sicard, Gea Oliveri Conti et al. “Acute myocardial infarction and COPD attributed to ambient SO2 in Iran.” Environmental Research 156 (2017): 683-687.

Research Summary Researchers from the United States, Iran, and Italy, representing 11 institutions, studied the health effects on myocardial infarction (MI) and chronic obstructive pulmonary disease (COPD) of short term exposure to sulfur dioxide (SO₂) in Iran using the AIRQ software developed by the World Health Organization (WHO). Daily average SO₂ concentrations were used as the estimates of human short-term exposure and allow calculation of the attributable excess relative risk of an acute MI and hospital admissions due to COPD. Statistical analysis showed an increased risk for MI and COPD attributable to high levels of SO₂.  

BE QUIET

Reference Schmidt, Frank, Kristoffer Kolle, Katharina Kreuder, Boris Schnorbus, Philip Wild, Marlene Hechtner, Harald Binder, Tommaso Gori, and Thomas Münzel. “Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease.” Clinical Research in Cardiology 104, no. 1 (2015): 23-30.

Research Summary Researchers from Johannes Gutenberg University, Germany explored the association between nighttime aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease are known to have more future cardiovascular events. Sixty patients with vessels disease were randomly assigned to one of two groups: 1) exposed to simulated aircraft noise; 2) no noise. Noise was simulated in the patients’ bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (blood flow of the brachial artery), questionnaires, and blood sampling were performed on the morning after each study night. Results showed nighttime aircraft noise markedly impaired endothelial function in patients with or at risk for cardiovascular disease. The vascular effects (including an increase in systolic blood pressure) appeared to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.

Reference Halonen, Jaana I., Anna L. Hansell, John Gulliver, David Morley, Marta Blangiardo, Daniela Fecht, Mireille B. Toledano et al. “Road traffic noise is associated with increased cardiovascular morbidity and mortality and all-cause mortality in London.” European heart journal 36, no. 39 (2015): 2653-2661.

Research Summary Researchers from multiple institutions in the United Kingdom examined the effects of long-term exposure to road traffic noise on hospital admissions and death in over eight million inhabitants of London. Assessments were completed of small-area-level associations of day (7:00 a.m. – 10:59 p.m.) and nighttime (11:00 p.m. – 6:59 a.m.) road traffic noise with cardiovascular hospital admissions and all-medical cause and cardiovascular death in adults (equal to or greater than 25 years) and elderly (equal to or greater than 75 years). The results showed long-term exposure to road traffic noise was associated with increased risk of all-medical condition death and death from cardiovascular disease in the general population, particularly for elderly people who have had a stroke.

ACTIVITY

GET 150 MINUTES EACH WEEK

Reference Almeida, Osvaldo P., Karim M. Khan, Graeme J. Hankey, Bu B. Yeap, Jonathan Golledge, and Leon Flicker. “150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12 201 older Australian men.” Br J Sports Med 48, no. 3 (2014): 220-225.

Research Summary Researchers from University of Western Australia, Australia explored the association between physical activity and improved survival (living longer) in 12,201 men aged 65-83 years who were followed for 10-13 years. Participants who reported 150 minutes of vigorous activity per week were considered physically active, which was assessed at the beginning and end of the follow-up period. Survival was monitored during the follow-up period and, at study exit, also assessed were mood, cognition, and functional status of the survivors. Healthy aging was defined as being alive at the end of follow-up and having no major difficulty in any daily living and a score of greater than 10 on the Patient Health Questionnaire. Results showed active men had lower risk of death over 10-13 years than physically inactive men. Physically active men had greater chance of fulfilling criteria for healthy aging than inactive men. Men who were physically active at the baseline and follow-up assessments had the highest chance of living longer compared with inactive men.

Reference Stewart, Ralph AH, Claes Held, Nermin Hadziosmanovic, Paul W. Armstrong, Christopher P. Cannon, Christopher B. Granger, Emil Hagström et al. “Physical activity and mortality in patients with stable coronary heart disease.” Journal of the American College of Cardiology 70, no. 14 (2017): 1689-1700.

Research Summary Researchers from eight countries, representing 13 institutions, analyzed the association between self-reported exercise and death in patients with stable cardiovascular heart disease (CHD) death from other conditions and myocardial infarction (MI). Over 15,000 patients from 39 countries with stable CHD who participated in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) study completed questions at baseline on hours spent each week doing no exercise, mild, moderate, and vigorous exercise. Results showed a graded decrease in death with increased habitual exercise, which was steeper with higher exercise levels, the greatest decrease in individuals exercising 160 minutes per week. The link between the decrease in death and greater physical activity was the strongest in the patients with the highest risk for CHD. 

BE CLEVER

Reference He, Dan, Bo Xi, Jian Xue, Pengcheng Huai, Min Zhang, and Jun Li. “Association between leisure time physical activity and metabolic syndrome: a meta-analysis of prospective cohort studies.” (2014): 231-240.

Research Summary Researchers from Shandong University, China reviewed 17 eligible studies on the association between leisure time physical activity and metabolic syndrome, retrieved by search of the medical literature through June 2013. Based on a statistical analysis, those with high levels of leisure time physical activity have a lower risk of having metabolic syndrome (three or more heart disease risk factors) than those with low levels of physical activity. When comparing people with moderate and low levels of physical activity, the moderate exercisers had a lower risk of metabolic syndrome if they were either male or if they were followed for 10 years or more.

MIX IT UP

Reference Croymans, D. M., S. L. Krell, C. S. Oh, M. Katiraie, C. Y. Lam, Ryan A. Harris, and C. K. Roberts. “Effects of resistance training on central blood pressure in obese young men.” Journal of human hypertension 28, no. 3 (2014): 157.

Research Summary Researchers from University of California, Los Angeles, United States explored the effects of high-intensity resistance training on blood pressure in overweight or obese, sedentary young men. Thirty-six participants were given randomized training schedules: 12 weeks of training (three times per week) or control groups (12 weeks of no training and assessed) for changes in central and brachial blood pressure, body composition, lipids and inflammatory markers. High-intensity resistance training resulted in decreased central and brachial systolic/diastolic blood pressures independent of weight loss and changes in arterial stiffness.

Reference Weston, Kassia S., Ulrik Wisløff, and Jeff S. Coombes. “High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis.” Br J Sports Med 48, no. 16 (2014): 1227-1234.

Research Summary Researchers from University of Queensland and University of Science and Technology, Australia systematically reviewed 10 studies with 273 participants, to quantify the efficacy and safety of high-intensity compared to moderate-intensity in individuals with chronic cardiometabolic lifestyle diseases, including coronary artery disease, heart failure, hypertension, metabolic syndrome and obesity. High-interval significantly increased CRF by almost double compared to a nine percent increase from moderate-intensity training.

DON’T SETTLE FOR LESS

Reference de Souto Barreto, Philipe, Matteo Cesari, Sandrine Andrieu, Bruno Vellas, and Yves Rolland. “Physical activity and incident chronic diseases: a longitudinal observational study in 16 European countries.” American journal of preventive medicine 52, no. 3 (2017): 373-378.

Research Summary Researchers from multiple institutions studied the association between physical activity and reduced risk for the onset of several chronic diseases. Researchers studied a large sample of citizens from 16 European countries using data collected between 2004-2013 from the longitudinal Survey of Health, Aging, and Retirement in Europe. Compared with people who never do physical activity, those doing vigorous physical activity once a week had a statistically reduced risk of developing heart disease. The magnitude of those associations increased with higher frequencies and exercise intensity. The authors concluded that doing physical activity once a week, which is less than current recommendations in terms of frequency, is associated with reduced risk of developing cardiovascular disease.

Reference Alsaleh, Eman, Richard Windle, and Holly Blake. “Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan.” BMC public health 16, no. 1 (2016): 643.

Research Summary Researchers from Philadelphia University, United States and University of Nottingham, United Kingdom assessed the impact of a behavioral intervention (BI) to increase physical activity in patients with coronary heart disease, not attending cardiac rehabilitation programs. The BI included one face-to-face consultation, six telephone support calls (for goal-setting, feedback, and self-monitoring) and 18 reminder text messages. Outcomes were assessed at baseline and six months. Primary outcomes were physical activity level, blood pressure, body mass index, exercise self-efficacy for exercise, and health-related quality of life. Walking significantly increased in the group that trained compared with the group that did no training. The training group had significantly lower blood pressure, lower body mass index, greater exercise self-efficacy, and better health-related quality of life at six months compared with the no exercise group.

JOIN A GROUP 

Reference Schulz, Amy J., Barbara A. Israel, Graciela B. Mentz, Cristina Bernal, Deanna Caver, Ricardo DeMajo, Gregoria Diaz et al. “Effectiveness of a walking group intervention to promote physical activity and cardiovascular health in predominantly non-Hispanic Black and Hispanic urban neighborhoods: Findings from the Walk Your Heart to Health Intervention.” Health Education & Behavior 42, no. 3 (2015): 380-392.

Research Summary Researchers from University of Michigan, United States evaluated the effectiveness of the 32-week Walk Your Heart to Health (WYHH) intervention on community residents between 2009 and 2012. Groups met three times per week at community based organizations and walked for 45 to 90 minutes (increasing over time). The study used a randomized control design to evaluate the effectiveness of WYHH, with participants randomized into training or no training groups. Psychosocial, clinical, and anthropometric data were collected at baseline, eight, and 32 weeks, and pedometer step data was tracked. Participants in the training group increased steps significantly more during the initial eight-week training period, compared with the no training group. Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference, and body mass index at eight weeks, and maintained at 32 weeks.

TRUST IN GOD

PRAY

Reference Ai, Amy L., Kevin L. Ladd, Chris Peterson, C. A. Cook, M. Shearer, and Harold G. Koenig. “Long-term adjustment after surviving open heart surgery: The effect of using prayer for coping replicated in a prospective design.” The Gerontologist 50, no. 6 (2010): 798-809.

Research Summary Researchers from University of Pittsburgh, United States studied the association between prayer and adjustment from undergoing open heart surgery (e.g. hope versus depression). Assessment capitalized on a preoperative survey and medical variables from the Society of Thoracic Surgeons National Database of patients undergoing open heart surgery. The current participants completed a mailed survey 30 months after surgery. Results showed participants that used prayer preoperatively for coping predicted lower levels of depression and higher levels of optimism and hope.

ATTEND WEEKLY CHURCH SERVICES

Reference Bruce, Marino A., David Martins, Kenrik Duru, Bettina M. Beech, Mario Sims, Nina Harawa, Roberto Vargas et al. “Church attendance, allostatic load and mortality in middle aged adults.” PloS one 12, no. 5 (2017): e0177618.

Research Summary Researchers from six institutions examined the association between religiosity (church attendance), a stress level measure called allostatic load (AL), and death from heart disease and other conditions. Data for this study was collected from NHANES III (1988-1994) on 5,442 participants between ages 40 and 65, who had values of at least nine out of 10 clinical/biologic markers used to drive AL, and had complete information on church attendance over the past 12 months. AL was derived from values for metabolic, cardiovascular, nutritional, and inflammatory clinical and biologic markers. Frequent churchgoers (more than once a week) had a 55% reduced risk of death from heart disease and other medical conditions compared with non-churchgoers. There was a significant association between church attendance and reduced death from heart disease and other medical conditions, among middle-aged adults. Non-churchgoers had higher stress (AL) scores when compared to frequent church goers.

BELIEVE IN GOD

Reference Ellison, Christopher G., Matt Bradshaw, Kevin J. Flannelly, and Kathleen C. Galek. “Prayer, attachment to God, and symptoms of anxiety-related disorders among US adults.” Sociology of Religion 75, no. 2 (2014): 208-233.

Research Summary Researchers from University of Texas at San Antonio and Baylor University, United States examined the relationship between religion and mental health. This study adds to the literature in this area by addressing two main questions: 1) is the frequency of prayer associated with symptoms of anxiety-related disorders among US adults? 2) is this association conditional on the nature of individuals’ attachment to God? Data was collected from the 2010 Baylor Religion Survey with over eleven hundred participants. Results reveal that prayer among individuals who had a secure attachment to God have less anxiety-related disorders compared to individuals who prayed with an avoidant attachment to God.

Reference Koenig HG. Religion, congestive heart failure, and chronic pulmonary disease. J Relig Health. 2002;41(3):263-278.

Research Summary A researcher from Duke University, United States studied 196 patients who were ages 55 or older admitted to Duke University Medical Center with a diagnosis of congestive heart failure to examine the prevalence of religious beliefs and practices and their relationships with physical and mental health. Many aspects of religious beliefs and practices were explored including private religious activities, religious attendance, and intrinsic religiosity. Assessments of religiosity included questionnaires such as the Hoge Intrinsic Religiosity Scale. Results indicated that religious beliefs and practices were associated with less disability, better functional capacity, and less shortness of breath.

HOPE FOR THE BEST

Reference Chida, Yoichi, and Andrew Steptoe. “Positive psychological well-being and mortality: a quantitative review of prospective observational studies.” Psychosomatic medicine 70, no. 7 (2008): 741-756.

Research Summary Researchers from University College London, United Kingdom systematically reviewed 70 eligible studies, 35 of health populations, and 35 disease populations, of the association between positive psychological well-being and death. The statistical analyses showed that both positive affect (e.g. emotional well-being, positive mood, joy, happiness, vigor, energy) and positive trait-like dispositions (e.g. life satisfaction, hopefulness, optimism, sense of humor) were associated with reduced death from cardiovascular disease in healthy population studies.

FIND YOUR PURPOSE IN LIFE

Reference Sacco, Shane J., Crystal L. Park, D. P. Suresh, and Deborah Bliss. “Living with heart failure: psychosocial resources, meaning, gratitude and well-being.” Heart & Lung: The Journal of Acute and Critical Care 43, no. 3 (2014): 213-218.

Research Summary Researchers from University of Connecticut, United States explored the experiences of people living with advanced heart failure (HF) to determine the extent to which they rely on social support and religion/spirituality to cope. Data was collected once and then again three months later from four open-ended questions (coded to identify psychosocial resources: positive meaning, gratitude, spirituality, social support, and medical resources) on living with HR, from 111 participants. Participants also completed measures of well-being, including religious meaning, life meaning, satisfaction with life, depressive symptoms, death anxiety, and health-related quality of life. Results showed that most patients reported utilizing many psychosocial resources, particularly positive meaning, religion/spirituality, social support, and medical resources. Positive meaning and religion/spirituality were linked to decreased symptoms. Religion/spirituality was also related to less death anxiety, while social support was related to higher anxiety about death three months later.

Reference Cohen, Randy, Chirag Bavishi, and Alan Rozanski. “Purpose in life and its relationship to all-cause mortality and cardiovascular events: a meta-analysis.” Psychosomatic medicine 78, no. 2 (2016): 122-133.

Research Summary Physicians from Mt. Sinai, St. Luke’s, and Roosevelt Hospitals and the Icahn School of Medicine, United States reviewed 10 prospective studies with a total of 136,265 participants, exploring the impact of purpose in life on all-cause mortality (death) and cardiovascular events. Possessing a higher sense of purpose in life was associated with a reduced risk of death from heart disease and other conditions. Future research should focus on linking purpose in life to health outcomes, as well as interventions to assist individuals identified as having a low sense of purpose in life.

INTERPERSONAL RELATIONSHIPS

SKIP THE DRAMA

Reference Kershaw, Kiarri N., Gretchen A. Brenes, Luenda E. Charles, Mace Coday, Martha L. Daviglus, Natalie L. Denburg, Candyce H. Kroenke et al. “Associations of Stressful Life Events and Social Strain with Incident Cardiovascular Disease in the Women’s Health Initiative.” Journal of the American Heart Association 3, no. 3 (2014): e000687. 

Research Summary Researchers from 11 institutions studied the association of stressful life events (SLE) and social strain with cardiovascular disease (CVD) and stroke. Data was collected from 82 Women’s Health Initiative Observational Study participants and used for the SLE and social strain analysis. Participants were followed for stressful events for up to 18 years. Results showed more stress life events and social strain was associated with higher incidence of heart disease and stroke, independent of sociodemographic characteristics, and depressive symptoms.

SOCIALIZE IN PERSON

Reference Compare, Angelo, Cristina Zarbo, Gian Mauro Manzoni, Gianluca Castelnuovo, Elena Baldassari, Alberto Bonardi, Edward Callus, and Claudia Romagnoni. “Social support, depression, and heart disease: a ten-year literature review.” Frontiers in psychology 4 (2013): 384.

Research Summary A multi-institution systematic review of five eligible studies was conducted by researchers from the United States, United Kingdom, and Italy on the association of psychosocial factors such as depression and low social support and the risk of heart disease, retrieved between 2002-2012. Depressive symptoms and the absence of social or marital support are significant risk factors for poor prognosis in cardiac patients. The authors concluded that cardiac rehabilitation and prevention programs should thus include not only the assessment and treatment of depression but also a specific component on the family and social support of patients.

Reference Valtorta, Nicole K., Mona Kanaan, Simon Gilbody, Sara Ronzi, and Barbara Hanratty. “Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies.” Heart 102, no. 13 (2016): 1009-1016.

Research Summary Researchers from University of York and Newcastle University, United Kingdom systematically reviewed 23 criteria eligible papers, including eleven heart disease studies and eight stroke studies, on the association between loneliness/social isolation and coronary heart disease (CHD)/stroke. Poor social relationships were associated with a 29% increase in risk of CHD and a 33% increase in risk of stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.

Reference Lima, Maria Luisa, Sibila Marques, Gabriel Muiños, and Cristina Camilo. “All you need is Facebook friends? Associations between online and face-to-face friendships and health.” Frontiers in psychology 8 (2017): 68.

Research Summary Four researchers from Instituto Universitário de Lisboa (ISCTE-IUL), Portugal compared face-to-face and virtual friendships and their association with health. Two large-scale studies were conducted in community samples (study one—350 urban residents; study two—803 urban and rural residents). Results showed that the number and quality of face-to-face friendships were directly associated with self-reported health status, however, the same did not occur with Facebook friendships. The authors concluded these results were similar to a previous study they conducted where they concluded that this pattern of results emphasizes the gains of face-to-face over online friendships.

VOLUNTEER

Reference Anderson, Nicole D., Thecla Damianakis, Edeltraut Kröger, Laura M. Wagner, Deirdre R. Dawson, Malcolm A. Binns, Syrelle Bernstein, Eilon Caspi, and Suzanne L. Cook. “The benefits associated with volunteering among seniors: a critical review and recommendations for future research.” Psychological bulletin 140, no. 6 (2014): 1505.

Research Summary Researchers from University of Windsor, University of California San Francisco, and York University, United States critically reviewed 73 eligible studies on volunteering health benefits in older adults. Results reveal that volunteering is associated with reduced symptoms of depression, better self-reported health, fewer functional limitations, and lower risk of death.

FIND A SUPPORT SYSTEM

Reference Robles, Theodore F., Richard B. Slatcher, Joseph M. Trombello, and Meghan M. McGinn. “Marital quality and health: A meta-analytic review.” Psychological bulletin 140, no. 1 (2014): 140.

Research Summary Researchers from University of California Los Angeles, United States conducted a meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marriage relationship quality and physical health in more than 72,000 individuals. Health outcomes examined included physical function, disease severity and mortality, and cardiovascular reactivity. Greater marital quality was related to better health and lower cardiovascular reactivity, such as lower BP and resting heart rate during marital conflict. Martial quality was associated with healthy behaviors, such as diet.

SPEND TIME WITH FURRY FRIENDS

Reference Chowdhury, Enayet K., Mark R. Nelson, Garry LR Jennings, Lindon MH Wing, Christopher M. Reid, and ANBP2 Management Committee. “Pet ownership and survival in the elderly hypertensive population.” Journal of hypertension 35, no. 4 (2017): 769-775.

Research Summary Researchers from Monash University and University of Tasmania, Australia analyzed data from the Second Australian National Blood Pressure study to assess the association of pet ownership and death from heart disease and other medical conditions over a long-term follow up among treated elderly hypertensive participants. Survey participants, ages 65-84, responded to a pet-ownership questionnaire during the year 2000. Survival information was determined over a median of 10.9 years with post-trial follow up a median 6.9 years. Statistical analysis indicated that pet ownership was associated with an improved cardiovascular disease survival in a treated elderly hypertensive population.

OUTLOOK

LOOK ON THE BRIGHT SIDE

Reference Kim, Eric S., Kaitlin A. Hagan, Francine Grodstein, Dawn L. DeMeo, Immaculata De Vivo, and Laura D. Kubzansky. “Optimism and Cause-Specific Mortality: A Prospective Cohort Study.” American journal of epidemiology 185, no. 1 (2017): 21-29.

Research Summary Researchers from Oxford University and Johns Hopkins Bloomberg School of Public Health, United States analyzed prospective data from the Nurses’ Health Study, with 70, 021 participants, on the association between optimism and the risk of poor health outcomes, especially cardiovascular disease, assessed from 2006-2012. Statistical analysis found a higher-degree of optimism was associated with a lower risk for premature death from cancer, heart disease, stroke, respiratory disease, and infection.

Reference Weiss-Faratci, Netanela, Ido Lurie, Yael Benyamini, Gali Cohen, Uri Goldbourt, and Yariv Gerber. “Optimism During Hospitalization for First Acute Myocardial Infarction and Long-Term Mortality Risk: A Prospective Cohort Study.” In Mayo Clinic Proceedings, vol. 92, no. 1, pp. 49-56. Elsevier, 2017.

Research Summary Researchers from Hebrew University and Tel Aviv University, Israel studied the association between optimism (defined as generalized positive expectations about the future) and long-term mortality (living longer) in young survivors of myocardial infarction (MI). A subgroup of 664 patients, ages 65 and younger, drawn from the longitudinal Israel Study of First Acute Myocardial Infarction, completed an adapted Life Orientation Test (LOT) questionnaire during their hospitalization between February 15, 1992 and February 15, 1993. Additional sociodemographic, clinical, and psychosocial variables were measured at baseline; mortality (death) follow-up lasted through December 31, 2015. Results showed higher levels of optimism during hospitalization for MI were associated with reduced death rate over a two-decade follow-up period.

Reference Pänkäläinen, Mikko, Tuomas Kerola, Olli Kampman, Markku Kauppi, and Jukka Hintikka. “Pessimism and risk of death from coronary heart disease among middle-aged and older Finns: an eleven-year follow-up study.” BMC public health 16, no. 1 (2016): 1124.

Research Summary Research from University of Tampere, Finland investigated the connection between optimism, pessimism, and death from heart disease. This was an 11-year study with 2,815 participants consisting of three age groups: 1) 52-56; 2) 62-66; and 3) 72-76. Levels of optimism and pessimism of the study subjects were determined at baseline using a revised version of the Life Orientation Test (LOT-R). Eleven years later, those results and follow-up data about heart disease as a cause of death were used.  Results showed that those who died because of heart disease were significantly more pessimistic at baseline then the others, applying to both men and women. The highest score of pessimism was approximately 2.2 fold higher compared to the subjects with the lowest scores. The authors concluded that pessimism seems to be a substantial risk factor for death from heart disease.

LAUGH

Reference Hayashi, Kei, Ichiro Kawachi, Tetsuya Ohira, Katsunori Kondo, Kokoro Shirai, and Naoki Kondo. “Laughter is the best medicine? A cross-sectional study of cardiovascular disease among older Japanese adults.” Journal of epidemiology 26, no. 10 (2016): 546-552.

Research Summary Researchers from University of Tokyo, Japan evaluated the association between frequency of daily laughter with heart disease and stroke among community dwelling older Japanese women and men. Data from 20,934 individuals, ages 65 or older, who participated in the Japan Gerontological Evaluation Study in 2013 was analyzed. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Results showed that after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 times higher than those who reported laughing every day and 1.60 times higher for stroke.

LIVE WITH GRATITUDE

Reference Redwine, Laura S., Brook L. Henry, Meredith A. Pung, Kathleen Wilson, Kelly Chinh, Brian Knight, Shamini Jain et al. “Pilot randomized study of a gratitude journaling intervention on heart rate variability and inflammatory biomarkers in patients with stage B heart failure.” Psychosomatic medicine 78, no. 6 (2016): 667-676.

Research Summary Researchers from University of California San Diego, United States explored the relationship between gratitude (the practice of appreciating positive life features) and the progression and development of heart failure symptoms and improving quality of life. This pilot study randomized 70 patients, over 60 years of age, to an eight-week gratitude journaling intervention or treatment as usual. Assessments included the six-item Gratitude Questionnaire, resting heart rate variability (HRV), and an inflammatory biomarker index. At mid-intervention the six-item Gratitude Questionnaire was measured. At post-intervention measures were repeated but also included a gratitude journaling task. The gratitude intervention was associated with improved trait gratitude scores, reduced inflammatory biomarker index score, and a decrease in heart rate variability during the gratitude journaling task compared with treatment as usual. While large-scale studies with active control conditions are needed to confirm these findings, this study suggests that gratitude journaling may improve biomarkers related to the progression of heart failure, such as reduced inflammation.

Reference Cheng, Sheung-Tak, Pui Ki Tsui, and John HM Lam. “Improving mental health in health care practitioners: Randomized controlled trial of a gratitude intervention.” Journal of consulting and clinical psychology 83, no. 1 (2015): 177.

Research Summary Researchers from Hong Kong Institute of Education, China investigated whether directing practitioners’ attention to gratitude events in work could reduce stress and depressive symptoms. This study, conducted in five public hospitals, randomly assigned 101 practitioners in to three conditions: gratitude, hassle, and no treatment. Participants in the gratitude and hassle group wrote work-related gratitude and hassle diaries respectively twice a week for four consecutive weeks. A no-diary group served as control. Depressive symptoms and perceived stress were collected at baseline, post-treatment, and three-month follow-up. Results showed the effect of the writing a gratitude journal, compared with control or hassle, declined in stress and depressive symptoms over time. Hassle diary writers and no-diary writing groups had the same outcome.

Reference Mills, Paul J., Laura Redwine, Kathleen Wilson, Meredith A. Pung, Kelly Chinh, Barry H. Greenberg, Ottar Lunde et al. “The role of gratitude in spiritual well-being in asymptomatic heart failure patients.” Spirituality in clinical practice 2, no. 1 (2015): 5.

Research Summary Researchers from University of California San Diego, United States and University of Stirling, Scotland examined associations between gratitude, spiritual well-being, sleep, mood, fatigue, cardiac-specific self-efficacy, and inflammation in 186 men and women with Stage B asymptomatic heart failure, ages 66-76. Gratitude was assessed with a validated assessment tool designed to measure how frequently people feel gratitude. All other psychological markers were assessed with validated quantitative measures. Results showed that gratitude was associated with better sleep, less depressed mood, less fatigue, and better self-confidence to maintain cardiac function. Patients expressing more gratitude also had lower levels of inflammatory biomarkers.

FORGIVE 

Reference May, Ross W., Marcos A. Sanchez-Gonzalez, Kirsten A. Hawkins, Wayne B. Batchelor, and Frank D. Fincham. “Effect of anger and trait forgiveness on cardiovascular risk in young adult females.” The American journal of cardiology 114, no. 1 (2014): 47-52.

Research Summary Researchers from Florida State University, United States explored the association between anger, forgiveness, and cardiovascular risk factors. Tendency to anger (State-Trait Anger Expression Inventory-2) and TTF (Tendency to Forgive Scale) were evaluated in 308 healthy female volunteers allocated to three related, yet distinct, studies. Study one assessed beat-to-beat blood pressure (BP). Study two used assessed blood flow. Study three assessed 24-hour ambulatory BP and ambulatory artery stiffness. Results demonstrated that anger was significantly associated with increased ventricular work and heart oxygen consumption and high ambulatory BP. In contrast, forgiveness was associated with a more favorable heart (hemodynamic effects). These findings suggest that interventions aimed at decreasing anger while increasing forgiveness may be clinically relevant.

KNOW YOU ARE VALUABLE

Reference Taber, Jennifer M., Jennifer L. Howell, Amber S. Emanuel, William MP Klein, Rebecca A. Ferrer, and Peter R. Harris. “Associations of spontaneous self-affirmation with health care experiences and health information seeking in a national survey of US adults.” Psychology & health 31, no. 3 (2016): 292-309.

Research Summary Researchers from University of Florida, United States examined data from the 2013 Health Information National Trends Survey, completed by 2,731 respondents, on the association between self-affirmation (such as reflecting on one’s strengths and values) and involvement in medical process with healthcare provider. Spontaneous self-affirmation was related to positive outcomes in healthcare contexts, such as a more positive perception of communication with one’s provider, better perceived quality of care, and greater likelihood of asking questions in a medical appointment.

Reference Tang, David, and Brandon J. Schmeichel. “Self-affirmation facilitates cardiovascular recovery following interpersonal evaluation.” Biological psychology 104 (2015): 108-115.

Research Summary Researchers from Texas A&M University, United States conducted an experiment to test the hypothesis that self-affirmation reduces negative physical responses after receiving an insulting evaluation. Participants wrote an essay and received either neutral or insulting evaluative feedback about their essay from another participant. Then participants wrote about a core personal value (self-affirmation) or about a less important value (no self-affirmation). Lastly, participants played a competitive reaction time game that permitted them to blast their purported evaluator with noise. The results showed that mean arterial blood pressure increased in response to being negatively evaluated and returned to baseline more quickly following self-affirmation. Further, insulting (versus neutral) evaluative feedback caused a greater increase in heart rate, except among those who self-affirmed following the evaluation.

NUTRITION

REACH FOR PLANT FOODS

Reference Oyebode, Oyinlola, Vanessa Gordon-Dseagu, Alice Walker, and Jennifer S. Mindell. “Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data.” J Epidemiol Community Health (2014): jech-2013.

Research Summary Researchers from University College London, United Kingdom examined annual Health Surveys for England for 65,226 participants, ages 35 and older, from 2001-2008, on the association between fruit and vegetable consumption and all-cause cancer and cardiovascular mortality. Consuming up to seven servings of fruits and vegetables daily was associated with decreased all-cause mortality for cancer and heart disease. Consuming vegetables was most protective, while frozen and canned fruit consumption was associated with increased mortality. While further research into the effects of different types of fruit and vegetables are warranted, this study indicates that eating up to seven servings of fruit and vegetables has a protective effect on all-cause mortality for cancer and heart disease.

Reference Miller, Victoria, Andrew Mente, Mahshid Dehghan, Sumathy Rangarajan, Xiaohe Zhang, Sumathi Swaminathan, Gilles Dagenais et al. “Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study.” The Lancet 390, no. 10107 (2017).

Research Summary Researchers from 18 countries, representing 28 research institutions studied the association among intake of fruits, vegetables, and legumes with cardiovascular disease and deaths with 135,335 individuals, ages 35-70, without heart disease, in 18 counties, in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. Participants were enrolled into the study between January 1, 2003 and March 31, 2013 and completed standardized questionnaires related to their diets, lifestyle habits, health history, and medication use. Statistical analysis revealed the average combined fruit, vegetable, and legume intake was 3.91 servings per day. Higher total fruit, vegetable, and legume intake was significantly associated with major cardiovascular disease, myocardial infarction, death from heart disease, and death from other conditions. The lowest risk for heart disease was found in the group who ate three to four servings per day, compared to the control group, that did not increase their intake. Raw vegetable intake was strongly associated with a lower risk of overall death, whereas cooked vegetable intake showed a modest benefit against mortality.

Reference Zong, Geng, Alisa Gao, Frank B. Hu, and Qi Sun. “Whole grain intake and mortality from all causes, cardiovascular disease, and cancer.” Circulation 133, no. 24 (2016): 2370-2380.

Research Summary A systematic review was conducted by researchers from Harvard to summarize the relationship between whole-grain intake and risk of dying from heart disease and other conditions. Twenty prospective cohort studies were included in the systematic review. Nine studies reported total whole-grain intake and 11 others reported specific whole-grain food intake, including 2,282,603 participants. A greater intake of both total whole grains and specific whole-grain foods was significantly associated with a lower risk of death from heart disease and other conditions in the meta-analysis. The authors reported that each additional three servings total whole grains per day was associated with a 25% lower risk of mortality (death) from cardiovascular disease.

Reference Grosso, Giuseppe, Justin Yang, Stefano Marventano, Agnieszka Micek, Fabio Galvano, and Stefanos N. Kales. “Nut consumption on all-cause, cardiovascular, and cancer mortality risk: a systematic review and meta-analysis of epidemiologic studies.” The American journal of clinical nutrition 101, no. 4 (2015): 783-793.

Research Summary Researchers from University of Catania, Italy systematically reviewed prospective studies that explored the effect of nut consumption on all-cause cancer and cardiovascular disease, and quantified the size effect with a meta-analysis. Seven studies for all-cause mortality, six studies for CVD mortality, and two studies for cancer mortality were included in the meta-analysis with a total of 354,933 participants. One serving of nuts per week resulted in a four percent decreased risk of all-cause mortality and one serving per day resulted in a 27% decrease in risk of dying from heart disease and other conditions. Nut consumption was associated with specific health risks such as lower body mass index and lower smoking status as well as increased intake of fruit and vegetables.

Reference Jaceldo-Siegl, Karen, Ella Haddad, Keiji Oda, Gary E. Fraser, and Joan Sabaté. “Tree nuts are inversely associated with metabolic syndrome and obesity: the adventist health study-2.” PloS one 9, no. 1 (2014): e85133.

Research Summary Researchers from Loma Linda University, United States examined the relationships of nut consumption, metabolic syndrome (three or more risk factors for heart disease), and obesity in the Adventist Health Study-two (Adventist Health Study-two is phase two of a health research study of 96,000 Seventh-day Adventists in the U.S. and Canada). Analysis was conducted on clinical, dietary, body composition, and demographic data of 803 adults. Assessment of intake of total nuts, tree nuts, and peanuts was completed and then the subjects were classified into low tree nut/low peanut, low tree/high peanut, high tree nut/high peanut, and high tree/low peanut consumers. Results showed that eating one serving of tree nuts a week had significantly decreased risk of obesity and metabolic syndrome.

Reference Tonstad, S., N. Malik, and E. Haddad. “A high-fiber bean-rich diet versus a low-carbohydrate diet for obesity.” Journal of human nutrition and dietetics 27, no. s2 (2014): 109-116.

Research Summary Researchers from Loma Linda University, California studied the health benefits of a diet high in bean consumption in a randomized group of 173 women and men with an average body mass index (BMI) of 36 kg/m². The intervention group was assigned to a diet of 35.5 grams per day for women and 42.5 grams for men. The control group was assigned to eat a low carbohydrate diet. Both diets were introduced gradually over four weeks. Results showed that of the 71 % that completed the 16-week diet, there was an average weight loss of nine pounds in the group eating beans and 11.5 pounds in the group eating low carbohydrates. Low-density lipoprotein (LDL) cholesterol levels significantly decreased with the high-fiber diet versus low-carbohydrate diet, as did total cholesterol, whereas changes in other lipids and glucose did not differ. After 52 weeks, total cholesterol remained lower with the bean-rich diet.

Reference Kuchta, Agnieszka, Anna Lebiedzińska, Marcin Fijałkowski, Rafał Gałąska, Ewelina Kreft, Magdalena Totoń, Kuba Czaja et al. “Impact of plant-based diet on lipid risk factors for atherosclerosis.” Cardiology journal 23, no. 2 (2016): 141-148.            

Research Summary Research from Medical University of Gdańsk, Poland explored the effect of a vegan (no meat/no dairy) diet on the serum lipid profile on 42 patients, ages 23-38, with atherosclerosis, measured by carotid Doppler ultrasonography. The participant group consisted of 21 omnivores and 21 vegans. The results showed that the vegan subjects were characterized by lower parameters of lipid profile, total cholesterol, low density lipoprotein cholesterol. High density lipoprotein was apparently similar between groups.

Reference Pettersen, Betty J., Ramtin Anousheh, Jing Fan, Karen Jaceldo-Siegl, and Gary E. Fraser. “Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2).” Public health nutrition 15, no. 10 (2012): 1909-1916.

Research Summary Researchers from Loma Linda University, United States examined the association between a vegetarian diet and blood pressure levels, in the Adventist Health Study (AHS), a health research study of 96,000 Seventh-day Adventists in the U.S. and Canada. Data was analyzed from 500 participants in a subgroup of phase two of the AHS who attended clinics and provided validated information who fell in to one of three groups: vegans (no meat/no dairy), vegetarians (no meat/eats dairy), and omnivores (eats meat and dairy). Clinics were conducted at churches across the U.S. and Canada. Dietary data were gathered by mailed questionnaire. Statistical analysis showed that the vegan diet had the lower systolic and diastolic BP and less risk of hypertension (defined as systolic BP >139 mmHg or diastolic BP >89 mmHg or use of antihypertensive medications) compared to the omnivore diet, after adjusting for body mass index. In addition, the vegan group were also less likely to be using antihypertensive medication.  

DINE OUT WISELY

Reference Lu, Yuan, Kaveh Hajifathalian, Majid Ezzati, Mark Woodward, Eric B. Rimm, and Goodarz Danaei. “Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1· 8 million participants.” (2014): 970-983.

Research Summary Two hundred and seventy-five researchers collaborated on a systematic review of 97 cohort studies that enrolled 1,800,000 participants, published between 1948 and 2005, to explore the association between overweight/obesity and coronary heart disease and stroke. In addition, the relationships between blood pressure, cholesterol, and blood glucose and heart disease and stroke was examined. Both overweight (BMI ≥25 to <30 kg/m²) and obesity (BMI ≥30 kg/m²) were associated with a significantly increased risk of coronary heart disease and stroke, compared with normal weight (BMI ≥20 to <25 kg/m²). The results showed that interventions that reduce high blood pressure, cholesterol, and glucose might address about half of the risk of coronary heart disease and three-quarters of the risk of stroke associated with high body mass index.

EAT BREAKFAST

Reference Uzhova, Irina, Valentín Fuster, Antonio Fernández-Ortiz, José M. Ordovás, Javier Sanz, Leticia Fernández-Friera, Beatriz López-Melgar et al. “The Importance of Breakfast in Atherosclerosis Disease: Insights From the PESA Study.” Journal of the American College of Cardiology 70, no. 15 (2017): 1833-1842.

Research Summary Researchers from Tufts University, United States and Centro Nacional de Investigaciones Cardiovasculares Carlos III, Spain examined the association between different breakfast patterns and cardiovascular disease risk factors. Analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study on 4,052 adults, ages 40-54, with no heart disease at the start of study. Three patterns of breakfast consumption were studied: 1) high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); 2) low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); 3) skipping breakfast, when consuming <5% of total daily energy (3% of the population). The results showed that habitually skipping breakfast was associated with a higher prevalence of atherosclerosis.

HYDRATE WITH WATER

Reference Chan, Jacqueline, Synnove F. Knutsen, Glen G. Blix, Jerry W. Lee, and Gary E. Fraser. “Water, other fluids, and fatal coronary heart disease: the Adventist Health Study.” American journal of epidemiology 155, no. 9 (2002): 827-833.

Research Summary Researchers from Loma Linda University, United States examined the association fatal coronary heart disease and intake of water, and fluids other than water, in the Adventist Health Study (a health research study of 96,000 Seventh-day Adventists in the U.S. and Canada). Among 8,280 male and 12,017 female participants, ages 38-100, who were without heart disease, stroke, or diabetes at baseline in 1976. Results revealed that of the 246 fatal heart disease events during the six-year follow-up, those that had high-daily intakes of water (five or more glasses) compared with low (two of fewer glasses) had a significantly lower risk for fatal heart events than those with who drank both lower levels of water or drank fluids other than water, after adjusting for age, smoking, hypertension, body mass index, education, and (in women only) hormone replacement therapy. The authors concluded that fluid intake as a putative coronary heart disease risk factor may deserve further consideration in other populations or using other study designs.

KNOW WHAT FOODS TO AVOID

Reference Wang, Miao, Andrew E. Moran, Jing Liu, Yue Qi, Wuxiang Xie, Keane Tzong, and Dong Zhao. “A meta-analysis of effect of dietary salt restriction on blood pressure in Chinese adults.” Global heart 10, no. 4 (2015): 291-299.

Research Summary Researchers at Capital Medical University, China and Columbia University Medical Center, United States conducted a systematic review on the effects of dietary salt reduction on blood pressure in Chinese adults, with 14 studies meeting eligible criteria. The total number of participants was over 8,000 people. The study criteria for inclusion was a 24-hour urinary sodium excretion test, salt intake measurement, and blood pressure before and after dietary salt lowering. Statistical analysis showed a 1.71 times reduction on systolic blood pressure (BP) in hypertensive participants compared with the non-hypertensive group. Salt-substitution did not result in a statistically significant reduction in BP. The authors concluded that salt restriction lowers mean BP in Chinese adults, with the strongest result among people with high BP.

Reference Micha, Renata, Jose L. Peñalvo, Frederick Cudhea, Fumiaki Imamura, Colin D. Rehm, and Dariush Mozaffarian. “Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States.” Jama 317, no. 9 (2017): 912-924.

Research Summary Researchers from Tufts Friedman School of Nutrition Science and Policy, United States and University of Cambridge, England estimated associations of intake of 10 specific dietary factors with death due to heart disease, stroke, and type 2 diabetes among U.S. adults. A comparative risk assessment incorporated data on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: participants = 8104; 2009-2012: participants = 8516). Exposures included: consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium. Results showed the largest numbers of estimated diet-related cardiometabolic deaths were related to high sodium, low nuts/seeds, high processed meats, low omega-3 fats, low vegetables, low fruits, and high sugary beverages. Between 2002 and 2012, population-adjusted U.S. cardiometabolic deaths per year decreased by 26.5%. The greatest decline was associated with insufficient polyunsaturated fats, nuts/seeds, and excess sugary beverages. The greatest increase was associated with unprocessed red meats.

Reference Li, Yanping, Adela Hruby, Adam M. Bernstein, Sylvia H. Ley, Dong D. Wang, Stephanie E. Chiuve, Laura Sampson et al. “Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study.” Journal of the American College of Cardiology 66, no. 14 (2015): 1538-1548.

Research Summary Researchers from Harvard Medical School, Harvard T H Chan School of Public Health, and Cleveland Clinic, United States conducted a 24-30 year follow up study of 84,628 women (Nurses’ Health Study, 1980-2019) and 42,908 men (Health Professionals Follow-up Study, 1986-2010) to investigate associations of saturated fats compared with unsaturated fats and different sources of carbohydrates in relation to cardiovascular heart disease risk. The participants were free of diabetes, heart disease, and cancer at start of study. Diet was assessed by a food frequency questionnaire every four years. Findings indicate that unsaturated fats, especially polyunsaturated fatty acids, and high-quality carbohydrates can be used to replace saturated fats to reduce heart disease risk.