Change your food habits

Just taking meds is not enough-there's a huge benefit in changing your food habits.

We often say that we should practise prevention. It's always nice to see this confirmed, and more importantly, quantified. We've discussed the differences between primary and secondary prevention. Secondary prevention is particularly important because heart disease is so often silent- the first sign of its presence may be a heart attack. Rather than being a cause for alarm or despair, knowing you have a heart condition can be the wakeup call you need.

The case for heart-healthy foods, a study from McMaster University in Canada that appeared in December last year showed that a diet rich in fruits, vegetables and fish significantly reduces the chance of a second heart attack and stroke in people with known cardiovascular disease. This was a five-year study of almost 32,000 older patients (average age 66 years) in 40 countries in Europe, the Americas, East and Southeast Asia and Africa. India and Pakistan were not included. Participants with cardiovascular diseases were asked how often they consumed milk, vegetables, fruits, grains, fish, nuts, meat and poultry over the past 12 months.

They were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. A healthy diet was indicated by a high intake of fruits, vegetables, wholegrains and nuts as well as a high intake of fish compared to meat, poultry and eggs. The reductions in risk for cardiovascular death, heart attack and stroke were 35%, 14% and 19%, respectively. The effect of a healthy diet was seen regardless of aspirin, beta-blocker or statin use, or the use of any combination of these wellknown drugs for secondary prevention. The findings were independent of the region of the world or whether from a middle-income country, or a high-income country. They were also independent of underlying high blood pressure, diabetes, elevated cholesterol or type of vascular disease (heart attack or stroke). In diabetics, the risk reduction from a healthy dietary pattern was the same as that from drug therapy! The dietary elements that were protective were: vegetables, fruit, soya protein and alcohol, while meat, poultry and eggs were associated with increased risk. Interestingly, there was no such protection from cancers, non-heart hospitalisations or injuries, suggesting that this dietary pattern is specific to heart disease. This is the first study to show that a high quality diet also significantly lowers risk in heart patients even if they are also taking medication to prevent a second heart attack, stroke or death. Since at least 20 million people worldwide survive a heart attack or stroke every year, the results are very important. Impressively robust, they appear to confirm the wisdom of prevention regardless of situation.

What this means for you even if your blood pressure, blood sugar and blood cholesterol are 'perfect' on your doctor's visits, because of the medication you are taking, you can still improve your health further through diet. Equally important is the realisation that when drugs cause side-effects and can't be tolerated- there is still an enormous amount of benefit associated with a healthy diet. Many of my patients come to me because their doctors have been pushing them too hard to take their pills, despite difficult-to-handle sideeffects. I tell them that the pills are important, and they should try their best to take them, but that they can do a lot for their health even if they can't take their medicines. Diet can be as powerful as drugs.