Can small diet changes really impact heart disease risk?

Heart disease remains the leading cause of death in Australia. Sounds grim, but experts say you can largely control your risk through a healthy diet and lifestyle.

Heart disease is a major killer in Australia, accounting for around one in every 10 deaths each year.

It’s a staggering number – especially when you consider 90 per cent of cardiovascular disease (CVD) risk is preventable.

A 29-year observational study into the link between diet and CVD risk by Deakin University has underlined the impact modifiable factors can have on reducing the rate of death.

Over the course of the study, between 1990 and 2019, diet-related CVD deaths decreased by almost 20 per cent.

“This study highlights that diet is really important (in reducing CVD risk), and it’s something you can do something about,” study co-author and dietitian Dr Elena George says.

“Every little change (we make to our diet) counts.

“No change is too small – we get overwhelmed trying to make drastic changes to our diet, but I think small and steady changes are going to have profound public health benefits.”

What influences cardiovascular disease risk?

CVD is an umbrella term that refers to all conditions impacting the heart or blood vessels, including coronary heart disease (clogged arteries), stroke, heart failure and peripheral artery disease.

As well as heart disease being the leading cause of death, more than 1.2 million Australians are living with illness related to CVD.

The good news is the majority of risk factors for CVD are ones we can do something about.

These include smoking, cholesterol, high blood pressure, being inactive, diabetes, being overweight, and an unhealthy diet.

Risk factors we can’t alter include our age (our risk increases as we get older), gender (men have a greater risk, though women may have an equal risk following menopause), ethnic background, and family history.

How diet impacts heart disease risk

It has long been known that dietary choices impact our health.

Diets high in whole grains, vegetables, fruit, legumes and nuts, and low in salt, free sugars and fats – particularly saturated and trans fats – are associated with good health and greater life expectancy.

The Global Burden of Disease study names diet as a key factor behind rising hypertension, diabetes, obesity and other CVD components.

The Deakin study was able to identify the types of dietary choices that saw the least decrease in rate of death and years living with heart-related illness.

“While the age-standardised burden of diet-related CVD deaths, years lived with disability, years of life lost, and disability-adjusted life years in Australia has reduced since 1990, these rates have plateaued since 2010,” Associate Professor Shariful Islam, who was the Deakin University study lead, says.

“These results suggest that more needs to be done to reduce the diet-related CVD burden in Australia.”

The study found for women, diets high in red meat and for men, not enough wholegrains were the greatest diet-related contributors to heart disease-related death.

Diets high in sodium for women and high in processed meat for men were also observed as key risk factors.

“What we’re seeing is diet does contribute to CVD,” Dr George says.

“Over the years, we’ve seen CVD deaths that are attributable to diet reduce, but they are still exceptionally high, and exceptionally high given that it is a modifiable risk factor.”

Why dietary influence can be different for men and women

Physiological differences between genders contribute to why types of diet impact men’s and women’s risk factors differently, Assoc Prof Islam says.

“How food is processed, how food is stored is different for men and women, and a single risk factor might impact people differently,” Assoc Prof Islam says.

The best food choices for a healthy heart

Dr George says it’s best to look to the Mediterranean diet for healthy heart dietary inspiration.

“With that we’ve got plant-rich foods, high-quality sources of fat, good oils and fish, nuts and seeds, more legumes, and pairing back on red meats,” she says.

The Deakin researchers say a whole-of-diet approach emphasising more wholegrains and legumes and less red meat can help continue to lower CVD.

“We don’t draw on lifestyle advice and dietary advice as a management strategy for chronic disease enough,” Dr George says.

“We focus a lot on medications and other things, but we are not providing people with self-management strategies.

“What is important is for people who have chronic disease like cardiovascular disease to get individual advice that is applicable to them.”

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Written by Claire Burke.