Premature Death: Reduce Your Risk by 31%

Written by Dr. Steve Chaney on . Posted in Premature Death

Add 3.4 Disease-Free Years To Your Life

Author: Dr. Stephen Chaney

reduce premature deathIf you could reduce your risk of:

  • Heart Disease (primarily heart attack) by 24%,
  • Stroke by 33%,
  • Cancer by 14%
  • Premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan),

Would you be interested in knowing more?

What if you could enjoy all these benefits:

  • Without it costing you an extra penny?
  • Without any side effects?
  • And you felt great?

Would you like to know the secret?  The secret is a diet rich in fruits and vegetables – probably a lot more fruits and vegetables than you are currently eating. Let’s look at the evidence.

How Was The Study Done?

reduce heart attacksYou may be saying “That’s not news. I’ve heard that before.” Yes, there have probably been hundreds of clinical studies looking at the benefits of diets rich in fruits and vegetables. There have also been several meta-analyses that have combined the data from many individual studies to improve that statistical power of their conclusions.

However, this study (Aune et al, International Journal of Epidemiology, DOI: 10.1093/ije/dyw319 ) is unique.

  • It is the largest and most comprehensive meta-analysis looking at the benefits of fruit & vegetable consumption ever undertaken.
  • It analyzed 142 published clinical studies with over 2.1 million subjects from around the globe.
  • There were 43,000 cases of heart disease, 47,000 cases of stroke, 112,000 cases of cancer, and 94,000 deaths in these studies.
  • It had enough statistical power to determine even minor effects of fruit and vegetable intake.
  • It is the first meta-analysis with enough data to accurately determine the optimal intake of fruits and vegetables.

 

Premature Death:  Reduce Your Risk By 31%

reduce premature death by eating fruits and vegetablesFor most of the health outcomes examined in this study, the optimal intake of fruits and vegetables was 10 servings a day. When they compared people who were consuming 10 servings a day to people who were consuming less than one serving a day,

  • Heart disease was reduced by 28%.
  • Stroke was reduced by 33%.
  • Premature death was decreased by 31%.
  • The fruits and vegetables most strongly associated with this benefit were apples, pears, citrus fruit, green leafy vegetables, and cruciferous vegetables.

For cancer, the optimal intake of fruits and vegetables was 6 servings a day. When they compared people who were consuming 6 servings a day to people who were consuming less than one serving a day,

  • Cancer was reduced by 14%.
  • The fruits and vegetables most strongly associated with reduced cancer risk were green vegetables such as green beans, yellow vegetables such as peppers and carrots, and cruciferous vegetables.

The authors speculated that the relatively small reduction in cancer risk they observed may have been because they were looking at total cancer cases rather than looking at individual cancers. Previous studies have suggested that fruits and vegetables reduce the risk of some cancers much more than others.

Finally, the authors estimated that:

  • 6 million premature deaths/year worldwide could be prevented if people consumed 6 servings of fruits and vegetables a day, and…
  • 8 million premature deaths/year worldwide could be prevented if people consumed 10 servings of fruits and vegetables a day.

What Does This Mean For You?

When the USDA rolled out the “Food Guide Pyramid” in 1992, they recommended 2-4 servings of fruit and 3-5 servings of vegetables a day. They tried educating the American public for almost a decade to no avail. Only 3% of Americans even came close to that recommendation.

In 2011 they threw in the towel and introduced “My Plate”, which recommended 5 servings (2 fruits and 3 vegetables). This is also the current recommendation of the WHO and England. “How well are we doing with this recommendation?”, you might ask.

good news bad newsThe answer is “not very well.”  The bad news is the CDC estimates that less than 13% of Americans eat 2 servings of fruit and 2-3 servings of vegetables a day. An average American eats one serving of fruit a day and less than 2 servings of vegetables a day. Clearly, we have a long way to go.

My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.

The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:

  • Heart disease would be reduced by 8%
  • Stroke would be reduced by 13%
  • Cancer would be reduced by 3%.
  • Premature death would be reduced by 10%

If we were to increase our intake of fruits and vegetables to even 6 servings a day:

  • Heart disease would be reduced by 16%
  • Stroke would be reduced by 22%
  • Cancer would be reduced by 13%.
  • Premature death would be reduced by 27%.

What About Supplementation?

The authors of the study stated: “Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial to health. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements…”

I agree in principle. It is impossible to duplicate the myriad of nutrients found in whole foods in a supplement. More importantly, we can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.

However,

  • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
  • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
  • We know many of the beneficial nutrients found in those fruits and vegetables…

Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.  And, increase your intake of fruits and vegetables to decrease your risk of premature death.

 

The Bottom Line

 

  • A new meta-analysis that combined the data from 142 published clinical studies with over 2.1 million subjects has concluded that increasing our intake of fruits and vegetables to 10 servings a day would:
    • Reduce heart disease (primarily heart attacks) by 24%.
    • Reduce strokes by 33%.
    • Reduce cancer by 14%.
    • Reduce premature death by 31% (That would add approximately 3.4 years of disease-free years to your lifespan).
    • Result in 7.8 million fewer premature deaths/year worldwide.
  • The bad news is that:
    • The CDC estimates that less than 13% of Americans eat even 2 servings of fruit and 2-3 servings of vegetables a day.
    • The CDC also estimates that the average American eats one serving of fruit and less than 2 servings of vegetables per day.
  • My guess is that only vegans come close to the recommended 10 servings a day, and that’s only if they skimp on beans, nuts, and grains so they can load up on fruits and vegetables.
  • The good news is every added serving of fruits and vegetables is beneficial. The authors of the study estimate that for every increase of 2.5 servings a day:
    • Heart disease would be reduced by 8%
    • Stroke would be reduced by 13%
    • Cancer would be reduced by 3%.
    • Premature death would be reduced by 10%
  • We can do better. We should all work towards increasing the amount of fruits and vegetables in our diet.
  • However,
    • When there is such a huge gap between what Americans are eating and the optimal intake of fruits and vegetables, and…
    • The USDA has tried for decades to get Americans to eat more fruits and vegetables without success, and…
    • We know many of the beneficial nutrients found in those fruits and vegetables…
  • Supplementation also makes sense. Choose a company that you can trust and try to fill the gap between what you need and what you are getting from your diet.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Do Omega-3s Lower Blood Pressure in Young, Healthy Adults?

Posted August 14, 2018 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

 

Do omega-3s lower blood pressure in healthy adults?

omega-3s lower blood pressure young adultsThe literature on the potential health benefits of omega-3s is very confusing. That’s because a lot of bad studies have been published. Many of them never determined the omega-3 status of their subjects prior to omega-3 supplementation. Others relied on dietary recalls of fish consumption, which can be inaccurate.

Fortunately, a much more accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes. Using modern technology, it can be determined from a single finger prick blood sample. It is a very accurate reflection of omega-3 intake relative to other fats in the diet over the past few months. More importantly, it is a measure of the omega-3 content of your cell membranes, which is a direct measure of your omega-3 nutritional status.

A recent extension of the Framingham Heart Study reported that participants with an Omega-3 Index >6.8% had a 39% lower risk of cardiovascular disease than those with an Omega-3 Index <4.2% (WS Harris et al, Journal of Clinical Lipidology, 12: 718-724, 2018 ). Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk, while 8% or better is considered indicative of low cardiovascular risk. For reference, the average American has an Omega-3 Index in the 4-5% range. In Japan, where fish consumption is much higher and cardiovascular risk much lower, the Omega-3 Index is in the 9-11% range.

Previous studies have suggested that omega-3 fatty acids lower blood pressure to a modest extent. Thus, it is not surprising that more recent studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, those studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Unfortunately, there were no studies looking at that population. The current study was designed to fill that gap.

 

How Was The Study Done?

omega-3s lower blood pressure young healthy adultsThe current study (M.G. Filipovic et al, Journal of Hypertension, 36: 1548-1554, 2018 ) was based on data collected from 2036 healthy adults, aged 25-41, from Liechtenstein. They were participants in the GAPP (Genetic and Phenotypic Determinants of Blood Pressure) study. Participants were excluded from the study if they had been diagnosed with high blood pressure and were taking medication to lower their blood pressure. They were also excluded if they had heart disease, chronic kidney disease, other severe illnesses, obesity, sleep apnea, or daily use of non-steroidal anti-inflammatory medications.

Blood samples were collected at the time of their enrollment in the study and frozen for subsequent determination of Omega-3 Index. Blood pressure was also measured at their time of enrollment in two different ways. The first was a standard blood pressure measurement in a doctor’s office.

For the second measurement they were given a wearable blood pressure monitor that recorded their blood pressure over 24 hours every 15 minutes during the day and every 30 minutes while they were sleeping. This is considered more accurate than a resting blood pressure measurement in a doctor’s office because it records the variation in blood pressure, while you are sleeping, while you are exercising, and while you go about your everyday activities.

 

Do Omega-3s Lower Blood Pressure In Young, Healthy Adults?

omega-3s lower blood pressure young adults equipmentNone of the participants in the study had significantly elevated blood pressure. The mean systolic and diastolic office blood pressures were 120±13 and 78±9 respectively. The average Omega-3 Index in this population was 4.6%, which is similar to the average Omega-3 Index in the United States.

When they compared the group with the highest Omega-3 Index (average = 5.8%) with the group with the lowest Omega-3 Index (average = 4.6%):

  • The office measurement of systolic and diastolic blood pressure was decreased by 3.3% and 2.6% respectively
  • While those numbers appear small, the differences were highly significant.
  • The 24-hour blood pressure measurements showed a similar decrease.
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index. [In studies of this kind, a linear dose-response is considered an internal validation of the differences observed between the group with the highest Omega-3 Index and the group with the lowest Omega-3 Index.]

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

 

What Does This Mean For You?

omega-3s lower blood pressure young adults questionPerhaps I should first comment on the significance of the relatively small decrease in blood pressure observed in this study.

  • These were young adults, all of whom had normal or near normal blood pressure.
  • The difference in Omega-3 Index was rather small (5.8% to 4.6%). None of the participants in the study were at the 8% or above that is considered optimal.
  • Liechtenstein is a small country located between Switzerland and Spain. Fish consumption is low and omega-3 supplement consumption is rare.

Under these conditions, even a small, but statistically significant, decrease in blood pressure is remarkable.

We should think of this study as the start of the investigation of the relationship between omega-3 status and blood pressure. Its weakness is that it only shows an association between high Omega-3 Index and low blood pressure. It does not prove cause and effect.

Its strength is that it is consistent with many other studies showing omega-3 fatty acids lower blood pressure. Furthermore, it suggests that the effect of omega-3s on blood pressure may also be seen in young, healthy adults who have not yet developed high blood pressure.

Finally, the authors suggested that a diet rich in omega-3s might reduce the incidence of high blood pressure by slowing the age-related increase in blood pressure that most Americans experience. This idea is logical, but speculative at present.

However, the GAPP study is designed to provide the answer to that question. It is a long-term study with follow-up examinations scheduled every 3-5 years. It will be interesting to see whether the author’s prediction holds true, and a higher Omega-3 Index is associated with a slower increase in blood pressure as the participants age.

 

Why Is The Omega-3 Index Important?

 

The authors of this study said: “The Omega-3 Index is very robust to short-term intake of omega-3 fatty acids and reliably reflects an individual’s long-term omega-3 status and tissue omega-3 content. Therefore, the Omega-3 Index has the potential to become a cardiovascular risk factor as much as the HbA1c is for people with diabetes…” That is a bit of an overstatement. HbA1c is a measure of disease progression for diabetes because it is a direct measure of blood sugar control.

In contrast, Omega-3 Index is merely a risk factor for cardiovascular disease. However, if it is further validated by future studies, it is likely to be as important for predicting cardiovascular risk as are cholesterol levels and markers of inflammation.

However, to me the most important role of Omega-3 Index is in the design of future clinical studies. If anyone really wants to determine whether omega-3 supplementation reduces cardiovascular risk, high blood pressure, diabetes or any other health outcome they should:

  • Start with a population group with an Omega-3 Index in the deficient (4-5%) range.
  • Supplement with omega-3 fatty acids in a double blind, placebo-controlled manner.
  • Show that supplementation brought participants up to an optimal Omega-3 Index of 8% or greater.
  • Look at health outcomes such as heart attacks, cardiovascular deaths, hypertension, stroke, or depression.
  • Continue the study long enough for the beneficial effects of omega-3 supplementation to be measurable. For cardiovascular outcomes the American Heart Association has stated that at least two years are required to obtain meaningful results.

These are the kind of experiments that will be required to give definitive, reproducible results and resolve the confusion about the health effects of omega-3 fatty acids.

 

The Bottom Line

 

An accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes.

Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk while 8% or better is considered indicative of low cardiovascular risk.

Previous studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, these studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Until now, there have been no studies looking at that population.

The study described in this article was designed to fill that gap. The participants in this study were ages 25-41, were healthy, and none of them had elevated blood pressure.

When the group with the highest Omega-3 Index (average = 5.8%) was compared with the group with the lowest Omega-3 Index (average = 4.6%):

  • Both systolic and diastolic blood pressure were decreased
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index.

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

Let me translate that last sentence into plain English for you. The authors were saying that optimizing omega-3 intake in young adults may slow the age-related increase in blood pressure and reduce the risk of them developing high blood pressure as they age. This may begin to answer the question “Do omega-3s lower blood pressure in young, healthy adults?”

Or even more simply put: Aging is inevitable. Becoming unhealthy is not.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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