Men Who Eat a Low-Risk Diet, Make Healthy Lifestyle Choices Can Reduce MI

Combining 5 low-risk behaviors-eating a healthy diet, consuming moderate amounts of alcohol, not smoking, being physically active, and maintaining a healthy weight-may prevent almost 80% of myocardial infarctions (MIs) among men, according to a new study.

“Adherence to a combination of healthy dietary and lifestyle practices may have an impressive impact on the primary prevention of MI,” state the authors, led by Agnetta Akesson, PhD, Senior Lecturer in Epidemiology at the Karolinska Institute in Stockholm, Sweden.

The researchers set out to examine the benefit of combined low-risk diet and healthy lifestyle practices on the incidence of MI in men. They conducted a population-based, prospective cohort study of more than 20,000 Swedish men, aged 45 to 79 years, who completed a detailed questionnaire on diet and lifestyle at baseline in 1997. The men who had no history of cancer, cardiovascular disease, diabetes, hypertension, or high cholesterol levels were followed through 2009.

Low-risk behaviors included 5 factors: a healthy diet, moderate alcohol consumption, no smoking, being physically active (walking or bicycling 40 or more minutes a day, and exercising 1 or more hours a week), and having no abdominal adiposity.

During 11 years of follow-up, the researchers found 1361 incident cases of MI. The low-risk dietary choice together with moderate alcohol consumption was associated with a relative risk of 0.65 compared with men having 0 of 5 low-risk factors. Men having all 5 low-risk factors compared with those with 0 low-risk factors had a relative risk of 0.14. “This combination of healthy behaviors, present in 1% of the men, could prevent 79% of the MI events on the basis of the study population,” the authors state.

The incidence of MI decreases with the number of positive behaviors in both healthy men and in those with hypertension and high cholesterol levels, they note.

In conclusion, the authors state, “Almost 4 of 5 MIs in men may be preventable with a combined low-risk behavior regimen. Further studies are needed to develop population-based strategies to promote healthy behaviors that can be introduced early in life and maintained throughout the life span.”

In an editorial, Dariush Mozaffarian, MD, DrPH, Adjunct Associate Professor of Epidemiology at the Harvard School of Public Health, stated that this study adds to previous reports “. . . by evaluating a large, contemporaneous study population enrolled from the general community.”

Dr Mozaffarian noted that “substantially lower MI risk was seen with adherence to very basic lifestyle behaviors.” For example, eating a diet richer in minimally processed, healthful foods was associated with a nearly 20% lower risk. “These healthful diets were neither extreme nor exceptional, but reasonable and consistent with dietary guidelines (about 5 daily servings of fruits and vegetables, 4 daily servings of whole grains, and 2 weekly servings of fish).” He emphasized that the observed benefits were related to higher intakes of more healthful foods, not lower intakes of unhealthy foods.

The researchers reported their results in the September 2014 issue of The Journal of American College of Cardiology.
 

References:

Åkesson A, Larsson SC, Discacciati A, Wolk A. Low-risk diet and lifestyle habits in the primary prevention of myocardial infarction in men: a population-based prospective cohort study. J Am Coll Cardiol. 2014;64:1299-1306.  doi:10.1016/j.jacc.2014.06.1190