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'Good' Carbs Cut Heart Disease Risk

Diets high in plant-based fibers seem to stave off coronary problems

MONDAY, Feb. 23, 2004 (HealthDayNews) -- While the debate rages on over low- and no-carbohydrate diets, a new study reiterates that a diet high in whole grains as well as fruits and vegetables significantly reduces the risk of heart disease.

"There is a lot of controversy right now about how much carbohydrate we should have in our diet verses fat and protein," says lead author Dr. Mark A. Pereira, an assistant professor of epidemiology at the University of Minnesota.

But this study, he says, reinforces the current dietary guidelines that suggest the base of your diet should be fiber-rich fruit, vegetables and grains.

Pereira and his colleagues collected data on 91,058 men and 245,186 women who participated in 10 studies in the United States and Europe. Each study looked at the foods the participants ate, and all studies measured the amount of fiber in the participants' diets.

During six to 10 years of follow-up, 5,249 people were diagnosed with heart disease and 2,011 participants died from it, the study says.

For each 10 grams of fiber consumed a day, the risk of heart disease was reduced by 14 percent, Pereira says. They also found a 27 percent decrease in the risk of dying from heart disease. The results, which appear in the Feb. 23 issue of the Archives of Internal Medicine, apply to both men and women.

The association between fiber and death from heart disease was particularly strong, the study says. For every 10 grams of cereal fiber consumed a day, the risk for death from heart disease was lowered by 25 percent. For every 10 grams of fruit fiber consumer daily, the risk dropped 30 percent.

However, the researchers did not find a link between vegetable fiber and reduced risk of heart disease. "We are not sure why that is," Pereira says.

The researchers determined the findings were independent of other factors that reduce the risk for heart disease, such as not smoking, exercising and weight control, he says.

"If you are concerned about your risk for heart disease, one of the key features of your diet should be plant-based foods," Pereira says. "In order to include 25 to 30 grams of fiber per day, your diet has to be primarily high-quality carbohydrates."

The benefits from grain come from whole grains -- not from highly processed grains, such as those found in white bread or white rice, he adds.

"We are not just talking about carbohydrate in general," Pereira says. "The key is to look at the quality of the carbohydrate. You can eat a very high-carbohydrate diet at fast-food restaurants, for example, but get almost no fiber, only lots of sugar and starch."

Dr. David L. Katz, director of the Yale Prevention Research Center at Yale University and author of The Way To Eat, says that "at another time, this might be a 'me-too' study, the term we somewhat disparagingly apply to studies that confirm what we already know."

But this is not any other time, Katz says: "It is the age of carbohydrate restriction. And in most instances, rapid weight loss is pursued on diets that toss out whole grains and fruits along with simple sugar and refined starch."

"Reducing intake of whole grains and fresh fruit is the last thing our population should be doing," he says. "We should not be cutting carbs wholesale, but rather cultivating health-promoting dietary patterns that prioritize wholesome carbohydrate foods but restrict highly processed carbohydrate foods."

"A diet rich in whole grains, fruits and vegetables, and otherwise moderate and balanced, is the tried-and-true formula for a better, healthier, longer life," Katz says.

More information

To learn more about healthy eating, check out offerings from the U.S. Department of Agriculture. For more on heart disease, visit the American Heart Association.

SOURCES: Mark A. Pereira, Ph.D., assistant professor, epidemiology, School of Public Health, University of Minnesota, Minneapolis; David L. Katz, M.D., M.P.H., associate clinical professor and director, Yale Prevention Research Center, Yale University, New Haven, Conn.; Feb. 23, 2004, Archives of Internal Medicine
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