Coronary heart disease is the leading cause of death in the
U.S. Every 34 seconds, an American life is claimed by heart
disease. In 1998, nearly 1 million Americans each year die from
heart disease. That's more lives than the next 7 causes of death combined.
But heart disease is not just a man's disease.
Although they largely are not aware of it, women are affected by heart disease as much
as men, even though it strikes females 10 years later in life. A Gallup survey of women
sponsored by the American Medical Women's Association found:
80
percent do not know that heart disease is the leading cause of death for females
70
percent believe heart attack warning signs are the same for women as they are for men (when
in actuality, they can be significantly different)
Only
50 percent know that menopause increases a woman's risk for heart disease
Other information on women and heart disease revealed that:
A woman
who has a heart attack is one-and-a-half times as likely as a man to die from it, and, if
she survives, more likely to have a second one. Framingham Heart Study
In
women, the rate of death from heart disease far exceeds that
of breast cancer. One woman in 25 dies of breast cancer. One
in two dies of cardiovascular disease, including a heart attack
or stroke. Heart disease is the number-one killer of women.
2003 American Heart Association Heart and Stroke Statistical
Update
In addition, a 1997 survey by Prevention magazine found that only 33 percent of
women surveyed knew that their chance of dying from breast cancer is less than that from a
heart attack. In fact, the risk is five times higher, but 58 percent thought it was lower
or the same risk.
But heart disease does not just develop overnight in men or women. It is a
disease that takes years to develop, according to researchers. Changes in the body that
eventually lead to heart disease begin in childhood and progress slowly as people age.
High blood cholesterol levels, one of the easiest risk factors to measure, clearly play a
role in the development of heart disease.
Good Nutrition is Key to Prevention
Although mortality from coronary heart disease has been declining in the U.S. for
years, unhealthy lifestyles including poor diet, obesity and lack of physical activity
are contributing to a slowdown in the progress that has been made against this disease,
according to the Centers for Disease Control and Prevention. Therefore, health
professionals are stepping up efforts to encourage consumers to adopt more heart-healthy
diets and to become more physically active.
Good nutrition always has been important in the prevention of heart disease. The
American Heart Association (AHA) makes a point of this in recently updated dietary
guidelines. These guidelines offer basic dietary advice that can help reduce the risk of
coronary heart disease in healthy adults and children over the age of two. The AHA
guidelines recommend that healthy individuals obtain adequate nutrients from foods eaten
in variety, balance and moderation. The guidelines stress balancing food intake with
physical activity and encourage selection of a diet that is:
low in
total fat, saturated fat and cholesterol;
rich in
fruits, vegetables, and whole grain products;
moderate
in sugar, salt, sodium and alcohol.
Current Thinking About Trans Fats and Hydrogenated Oils
Trans fatty acids ("trans fats") are a type of fat that occurs naturally in
beef, butter, milk and lamb. Trans fats also result from a specific process (partial
hydrogenation) that makes vegetable oils more solid, and thus more practical for various
food preparation applications. These solidified vegetable oils are used in many foods to
replace animal fats and tropical oils that are not only solid at room temperature, but are
known to contain significant amounts of saturated fat, which has been known for decades to
increase risk of heart disease.
Because research addressing trans fats has been in the news about a possible link with
heart disease risk, it often raises questions in consumers’ minds about the trans fat
content of foods. What consumers need to realize is that foods contain many fats (fatty
acids) that come together as building blocks of the fat. Any individual food that contains
any "fat" will also contain numerous fatty acids, each of which has a technical
name. In fact, "fats" in foods are similar to proteins that are comprised of a
variety of amino acids.
Much of the research that has generated news about trans fats does not look at whole
foods, but looks at the effect of a specific fatty acid (like trans fat). Researchers will
tell you that people do not each specific fatty acids, rather, they eat whole foods. For
example, some foods that contain a small amount of trans fats contain a much larger
proportion of unsaturated fats that are known to reduce risk of heart disease.
Trans fats comprise only 2-4 percent of the total calories consumed in the average
American diet. Since Americans typically consume 12-14 percent of calories from saturated
fat, health experts recommend consumers reduce saturated fat intake to no more than 10
percent of calories. Health professionals continue to stress that the focus should be on
the big nutrition picture a balanced diet and a reduction in total fat and saturated
fat to a more healthful level than currently being consumed today. If total fat in
particular is reduced, both the intake of saturated fat and trans fat will be reduced as
well.
Of course, there are many factors involved with heart disease risk, with dietary
factors just being one of them. For additional advice about making the appropriate changes
in your diet, check with a registered dietitian or other qualified health professional.
Margarine: The Healthier Tablespread
According to an article in the January 1999 Tufts University Health & Nutrition
Newsletter, "A recent study from the USDA’s Human Nutrition Research Center in
Beltsville, Maryland, helps answer the question (concerning butter or margarine).
Scientists there studied 46 men and women for several months, periodically varying the
type of spread they ate: butter, tub margarine, or trans-free tub margarine. The result:
both margarines significantly improved blood cholesterol levels over butter, helping to
put to rest any doubt about whether it would be better to switch back to butter from
margarine."
As
stated above, people eat whole foods, not individual fatty acids. At least eight studies
have demonstrated the health benefits of margarine as a food, including a recent study
that showed that foods rich in vitamin E, such as margarine, significantly reduced the
risk of heart disease in women.
The
American Heart Association and other leading health organizations still recommend soft and
liquid margarine over butter. Many of these products contain little or no trans. The
industry has reduced the trans content in many margarines to meet consumer needs and
preferences, just as it has reduced total fat, saturated fat and calories.
Saturated fats make up a larger portion of the fat in most diets than trans fats do, so
consumers need to focus their efforts on cutting saturated fats. Trans fats comprise only
2-4 percent of total calories consumed in the average American diet, while Americans
typically consume 12-14 percent of calories from saturated fat. Today’s margarine can
help consumers reach the goal of reducing saturated fat in the diet.
Even
when you combine the trans and saturated fat in margarine products, they still have a
better nutritional profile than butter. Compared to butter, margarine products contain
33-100 percent less of these two fats and many margarine products actually have little or
no trans fat. For those interested in reducing their intake of trans, some margarine
products (including sticks) are completely trans-free.
From the Mayo Clinic Health Letter
Q. What’s the current
thinking about trans fatty acids in margarine and the risk of heart disease?
A. Trans fatty acids don’t pose as much of a health concern as saturated
fats. Trans fatty acids are formed during hydrogenation. This process changes vegetable
oils into solid or semi-solid margarine or shortening.
Concern about trans fatty acids stems from research suggesting these fats raise blood
cholesterol and so increase your risk of cardiovascular disease. But trans fatty acids
don’t elevate blood cholesterol to the same degree as saturated fats. You also eat
them in smaller quantities.
To control blood cholesterol, your goal is to limit fat. When you do add fat to food,
the American Heart Association (AHA) recommends margarine instead of butter because butter
is high in saturated fats and cholesterol. The more liquid the margarine, such as tub or
squeeze-bottle varieties, the less hydrogenated it is and the fewer trans fatty acids it
contains.