Cardiovascular disease mortality rates have fallen by 50% during the past 50 years. However, cardiovascular disease prevalence remains high and remains the leading cause of death and disability in the United States, according to a paper recently published in Circulation (2009;119:1161-1175), the journal of the American Heart Association, Dallas. The report authors state that it has been estimated that preventive efforts have contributed to at least half of this decline, with the primary contribution coming from declines in mean blood cholesterol concentrations, mean blood pressure levels and tobacco use rates.
Unfortunately, during this past decade, the increased prevalence of obesity and diabetes has dramatically slowed this decline in cardiovascular mortality. In fact, in the United States, the contribution of prevention to the decline of cardiovascular mortality is now much lower than in other industrialized countries and the United States historically.
(The complete article can be downloaded athttp://circ.ahajournals.org/cgi/content/full/119/8/1161.)
Taking back control
Research shows that simple food choices go a long way when it comes to maintaining heart health. This includes choosing low-fat dairy foods.
A summary article of the symposium “Scientific Update on Dairy Fats and Cardiovascular Disease,” which was hosted by the University of Reading, United Kingdom, in June 2008 has recently been published online in the European Journal of Nutrition (www.springerlink.com/content/5w8g17n3l5511763/fulltext.pdf).
This review provides a reappraisal of the potential effects of dairy foods, including dairy fats, on cardiovascular disease. It resulted from concerns that commodities and foods containing saturated fats were being overly scrutinized for their impact on overall health of the population. A conference of scientists from different perspectives of dietary fat and health was convened in order to consider the scientific basis of these allegations.
The reviewers concluded that despite the contribution of dairy products to the saturated fatty acid composition of the diet, and given the diversity of dairy foods of widely differing composition, there is no clear evidence that dairy food consumption is consistently associated with a higher risk of cardiovascular disease. Thus, recommendations by the medical community to reduce dairy food consumption irrespective of the nature of the dairy product should be made with caution.
With that said, there are steps dairy foods manufacturers can take to improve the macro and micro nutrient profiles of their products.
For example, Racine, Wis.-based Alliance Enterprises now markets the Benelact process, which can achieve a 90% cholesterol reduction in skim milk and a 35% cholesterol reduction in whole milk (see table on page 49). This all-natural process extracts cholesterol from milk without altering the taste, texture or properties of the milk. The resulting milk can be consumed directly or used as an ingredient in other dairy-based products to produce healthy alternatives without sacrificing taste.
Sodium: the next target
High-salt diets have also been linked to an increase in blood pressure and an increased risk for a number of cardiovascular diseases including heart disease and stroke.
New data from the U.S. Centers for Disease Control and Prevention (CDC), Atlanta, provides additional scientific evidence that the majority of Americans over the age of 20 should limit the amount of sodium they consume daily to 1,500 milligrams to prevent and reduce high blood pressure. The new data are published in the March 26, 2009, issue of the CDC’s Mortality and Morbidity Weekly Report.
“In light of new data from the CDC, which show that 69% of adults are salt sensitive, the need to reduce sodium consumption has become an even higher priority for our country’s health,” says Linda Van Horn, chair of the American Heart Association’s Nutrition Committee and professor of Preventive Medicine at the Northwestern University Feinberg School of Medicine in Chicago.
“The American Heart Association recommends that most people strive to lower the amount of sodium consumed daily to less than 1,500 milligrams to prevent or manage high blood pressure, a major but modifiable risk factor for heart attack and stroke,” Van Horn says. “The new CDC data adds to a growing body of scientific evidence that supports this recommendation. There are now a substantial number of scientific studies that show a direct relationship between salt intake and a rise in blood pressure. An upper limit of no more than 1,500 milligrams could significantly reduce the rate of high blood pressure in the United States.”
The U.S. food supply contains excessive amounts of sodium, which makes limiting sodium consumption challenging. Within the dairy category, cheese products and some cultured dairy foods are the main culprits in regards to containing too much added sodium. The American Heart Association is currently working with federal agencies to identify strategies to reduce the amount of sodium in the food supply and is encouraging food manufacturers and restaurants to reduce the sodium added to food by 50% over the next 10 years.
According to new statistics announced at the American Heart Association’s 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention in early March, if Americans reduced their salt intake by just 1 gram per day, there would be 250,000 fewer new cases of heart disease and 200,000 fewer deaths in a decade.
These results were derived from a validated computer-simulation of heart disease among U.S. adults. “A very modest decrease in the amount of salt - hardly detectable in the taste of food - can have dramatic health benefits for the U.S.,” says Kirsten Bibbins-Domingo, lead author of the study and an assistant professor of Medicine and of Epidemiology at the University of California, San Francisco. “It was a surprise to see the magnitude of the impact on the population, given the very small reductions in salt that we were modeling.”
A 3-gram-a-day reduction in salt intake (about 1,200 milligrams of sodium) would result in 6% fewer cases of new heart disease, 8% fewer heart attacks and 3% fewer deaths. Even larger health benefits are projected for African Americans, who are more likely to have high blood pressure and whose blood pressure may be more sensitive to salt. Among African Americans, new heart disease cases would be reduced by 10%, heart attacks by 13% and deaths by 6%.
For years, ample evidence has linked salt intake to high blood pressure and heart disease. Yet, salt consumption among Americans has risen by 50% and blood pressure has risen by nearly the same amount since the 1970s, according to researchers.
“It’s clear that we need to lower salt intake, but individuals find it hard to make substantial cuts because most salt comes from processed foods, not from the salt shaker,” Bibbins-Domingo says. “Our study suggests that the food industry and those who regulate it could contribute substantially to the health of the nation by achieving even small reductions in the amount of salt in these processed foods.”
In addition to removing cholesterol and reducing sodium, dairy processors can add heart-healthy ingredients to their offerings. Dairy foods are an increasingly attractive carrier for many of these ingredients because of dairy’s refrigerated, relatively short shelf life. This reduces the chance of off-flavors and other undesirables from developing over time.
Expect to see more and more heart-healthy functional dairy foods show up in retailers’ refrigerators in 2009 and beyond. These products will tout that they reduce the risk of cardiovascular disease by either claiming to lower cholesterol or reduce blood pressure.
The most common heart-healthy ingredients being added to dairy foods are omega-3 fatty acids, plant sterols, soluble fiber and dairy peptides (see sidebar); however, there are a host of other ingredients recognized as being heart healthy and dairy processors are learning how to formulate these ingredients into products such smoothies, yogurt, cheese and others.
Ingredient options that work in dairy foods
Blueberries, raspberries, strawberries, in fact just about all edible berries, are highly concentrated sources of anti-inflammatories associated with reducing the risk of developing heart disease.
Almonds, walnuts and macadamia nuts are loaded with omega-3 fatty acids and mono- and polyunsaturated fats, all of which have been shown to contribute to cardiovascular health. Plus nuts increase fiber in the diet. Specifically, studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.
• Omega-3 fatty acids
Omega-3 fatty acids help the heart by reducing blood pressure and the risk of blood clots. In people who have already had heart attacks, omega-3 fatty acid intake has been shown to reduce the risk of sudden death.
• Plant sterols
Plant sterols or stanols are compounds found in plants that have been shown to block the absorption of cholesterol. These ingredients in foods do not appear to affect levels of triglycerides or of “good” high-density lipoprotein (HDL) cholesterol. Nor do they interfere with the absorption of the fat-soluble vitamins: vitamins A, D, E and K.
• Soluble fiber
Soluble fiber, such as that found in oats, reduces low-density lipoprotein (LDL), the “bad” cholesterol. Soluble fiber appears to reduce the absorption of cholesterol in the intestines.
Blood Pressure Ingredient Takes the Gold
A unique blood pressure management ingredient, tensVida (formerly known as TensGuard), won the NutrAward for the most innovative, evidence-based health and nutrition ingredient at the Nutracon conference in Anaheim, Calif., in early March. Selected by a panel of industry experts, scientists and nutritionists, plus votes from attendees, tensVida claimed this prestigious award, making it the first ingredient to win industry awards in both the United States and Europe, according to DSM Nutritional Products Inc., Parsippany, N.J., the ingredient’s marketer. TensVida had won the Gold award for most innovative new health ingredient at Health Ingredients Europe in November.
“As a well-known risk factor for coronary heart disease, kidney failure and stroke, high blood pressure is a major global concern,” says Pete Willis, senior marketing manager at DSM. “TensVida represents a major breakthrough to help maintain normal blood pressure. Opening up a new sector in the functional foods market, tensVida enables manufacturers to develop a wide range of food, beverage and dietary supplement products which can offer specific heart-health benefits.”
The product of advanced enzyme technology, tensVida is a milk-derived tripeptide that helps to maintain healthy blood pressure within the normal range. Tripeptides occur naturally in dairy products such as aged cheese and cultured milk. Scientific studies show that milk-derived tripeptides with the bioactive amino acid sequence IPP (isoleucine-proline-proline) can maintain healthy blood pressure in people who have blood pressure within the normal range. DSM uses advanced enzymatic hydrolysis to release the maximum effectiveness of these potent bioactive tripeptides to produce tensVida.
As today’s highest potency lacto-tripeptide, tensVida requires only a low dosage to be effective, making it more adaptable to heart-health formulations. It is odorless, clean tasting and entirely water soluble, making it suitable for a wide range of food and beverage applications. Natural tensVida satisfies consumers’ ingredient safety concerns as it has a documented history of safe use and is a specific nonstandardized food under 21CFR 102.22.
For more information, call 800/526-0189 or visitwww.dsm-functionalfoodsmarketing.com.
Sugary Drinks = Bad for Heart
According to a study published in the April edition of the American Journal of Clinical Nutrition, regular consumption of sugary beverages puts women at a higher risk for coronary heart disease. The study showed that women who consumed two or more servings of these beverages each day had a 35% higher risk of heart disease compared to those who consumed less than two servings per month.
The study defined sugar-sweetened beverages as carbonated and non-carbonated beverages that contain sugar-based caloric sweeteners and are flavored with fruit juice or natural and artificial flavors. It also included caffeinated and non-caffeinated colas, including low-calorie sweet beverages such as diet sodas.
The study authors controlled for factors such as smoking, lower levels of physical activity, higher body mass index numbers, consumption of more energy, saturated and trans fats, and consumption of less alcohol, fruit and vegetables, and found that women who had these behaviors also were more likely to consume sugar-sweetened beverages.
“We all know that drinking lots of sugary beverages is unhealthy,” according to the study’s lead researcher Teresa Fung, professor of nutrition at Simmons College, Boston. “This study looked specifically at how regular consumption of sugary beverages can lead to an increased risk of heart disease.”