How Important Is Diet To Your Health?
To avoid cardiometabolic diseases like heart disease, diabetes, and stroke, there’s likely nothing more important than following a healthy diet, asserts newly published research in the Journal of the American Medical Association (JAMA).1
Using data that dissected the diets of 702,308 American adults who died from cardiometabolic diseases, the scientists found that nearly half of those deaths – 45.4% – were linked with 10 dietary factors.
Salt | Top Killer
The single biggest dietary risk was salt. A diet high in salt, or sodium-chloride, accounted for nearly 10% of the total diet-related deaths.
The study’s authors defined a high-salt diet as more than 2,000 milligrams of sodium consumed daily. (The average American takes in about 3,500 milligrams of sodium per day.) Heart-health organizations like the American Heart Association and the Pritikin Longevity Center recommend no more than 1,500 milligrams of sodium daily.
10 Dietary Factors and Their Impact On Health
The 10 dietary factors (listed from highest to lowest health risk) were:
- High sodium intake (more than 2,000 mg of sodium daily):
9.5% of cardiometabolic deaths
- Low intake of nuts and seeds (fewer than five 1-ounce servings a week):
8.5% of cardiometabolic deaths
- High intake of processed meats (any intake incurred risk):
8.2% of cardiometabolic deaths
- Low intake of seafood omega-3 fats (fewer than 2 servings of fish a week):
7.8% of cardiometabolic deaths
- Low vegetable intake (fewer than 4 servings a day):
7.6% of cardiometabolic deaths
- Low fruit intake (fewer than 3 servings a day):
7.5% of cardiometabolic deaths
- High intake of sugar-sweetened beverages (any intake incurred risk):
7.4% of cardiometabolic deaths
- Low intake of whole grains (fewer than 2.5 servings a day):
5.9% of cardiometabolic deaths
- Low intake of polyunsaturated fats (fewer than 11% of calories, and used as a replacement for saturated fats and refined carbohydrates):
2.3% of cardiometabolic deaths
- High intake of unprocessed red meats (more than one 3.5-ounce serving a week):
0.4% of cardiometabolic deaths
Men At Greater Risk
The study also found that poor diet was associated with a larger proportion of deaths among men (49%) than women (42%).
In men, the top five dietary factors tied with cardiometabolic deaths were:
- Excess processed meats
- Excess sodium
- Excess sugar-sweetened beverages
- Insufficient nuts/seeds
- Insufficient seafood omega-3 fats
In women, the top five factors were:
- Excess sodium
- Insufficient nuts/seeds
- Insufficient vegetables
- Insufficient fruits
- Insufficient seafood omega-3 fats
Poor diet was also linked with a larger proportion of deaths among blacks and Hispanics versus whites, and among people with lower versus higher levels of education.
The authors, led by Renata Micha, PhD, RD, at Tufts University, acknowledged the limitations of their research. Most notably, theirs was an observational study, which means they could establish correlations between foods and diseases, but not cause-and-effect.
And yet, pointed out the authors, their findings were consistent with many prior U.S. studies of diet and cardiometabolic death.
For example, a large analysis2 by researchers at Harvard School of Public Health concluded that dietary factors contributed to “a substantial number of deaths in the U.S.” in the year 2005 alone. A high-sodium diet was associated with 102,000 cardiovascular deaths; a low intake of omega-3 fats, with 84,000 deaths; a high intake of trans fats, with 82,000 deaths; and low consumption of fruits and vegetables, with 58,000 deaths.
In global analyses of deaths related to diets high in sodium3 and diets high in sugar-sweetened beverages4 in 2010, about 58,000 U.S. cardiometabolic deaths were linked with excess sodium, and about 24,000 were linked with sugar-sweetened beverages.
Proven Benefits of a Heart-Healthy Diet
Moreover, in 100-plus studies published over the last 36 years, “We have found that regular exercise and a healthy diet, the Pritikin Eating Plan, yielded fast and profound improvements in cardiometabolic risk factors,” states UCLA distinguished professor emeritus James Barnard, PhD. Dr. Barnard was lead author of many of the Pritikin studies.
Results of the Pritikin Program of diet and exercise include:
- Reducing several risk factors5 for heart disease, including cholesterol, triglycerides, and inflammatory factors like C-reactive protein6
- Reducing blood pressure to normal or near-normal levels, and without the need for medications7
- Lowering blood sugar (glucose) in people with diabetes8 and reversing conditions like pre-diabetes and metabolic syndrome9
- Shedding excess weight10
Pritikin Diet & Eating Plan
There is nothing extreme about the Pritikin Diet except that it is extremely healthy. Fill your plate with the Healthiest Foods on Earth
The Right Dietary Factors?
A second concern regarding the published JAMA study is whether the 10 dietary factors selected were the right set “or whether some other dietary factors should be included and others removed,” pointed out Drs. Noel Mueller and Lawrence Appel of Johns Hopkins University in an editorial11 in the same issue of JAMA.
“For example, should saturated fat have been included among the dietary factors?” Randomized trials (a gold-standard study design that does prove cause-and-effect relationships) have in fact demonstrated that replacing saturated fat with polyunsaturated vegetable oil reduced cardiovascular disease events by 18 to 41%.12, 13, 14
Trans Fats, Sugar
Drs. Mueller and Appel also contend that strong arguments could be made for the inclusion of trans fats (also known as partially hydrogenated oils) and refined sugar in general (not just sugary beverages). Excess intakes of both are consistently linked with increased risk of cardiometabolic diseases and death.
Another possible factor on the “good” side of the dietary spectrum, they offered, was increased intake of foods rich in potassium, such as beans, dark leafy greens, baked potatoes with the skin on, squash, yogurt, mushrooms, and bananas.
Nuts and Seeds | Overrated?
Also, asserted Drs. Mueller and Appel, “many cardiometabolic prevention experts might argue that the effects of nuts and seeds [second highest risk in the JAMA study] are overestimated.”
How Important Is Diet To Your Health? | Bottom Line
Overall, concluded the JAMA study’s lead author Dr. Renata Micha and co-authors, diet matters in a very big way.
“Dietary factors were estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes. These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health.”
Concurred Drs. Mueller and Appel in their editorial: “…the likely benefits [of improved diet] are substantial and justify policies designed to improve diet quality.”
Salt: “A key target”
“Among unhealthful foods/nutrients, the present findings suggest that sodium is a key target,” summed up Dr. Micha and colleagues.
“Population-wide salt reduction policies that include a strong government role to educate the public and engage industry to gradually reduce salt content in processed foods (for example, as implemented in the United Kingdom and Turkey) appear to be effective, equitable, and highly cost-effective or even cost-saving.”15, 16
- 1 JAMA, 2017; 317(9): 912.
- 2 PLoS Medicine, 2009; 6(4) :e1000058. doi: 10.1371/journal.pmed.1000058. Epub 2009 Apr 28.
- 3 New England Journal of Medicine, 2014; 371(7): 624.
- 4 Circulation, 2015; 132(8): 639.
- 5 Archives of Internal Medicine, 1991; 151:1389.
- 6 Journal of Applied Physiology, 2006; 100: 1657.
- 7 Journal of Applied Physiology, 2005; 98: 3.
- 8 Diabetes Care, 1994; 17: 1469.
- 9 Circulation; 2002; 106: 2530.
- 10 Archives of Internal Medicine, 1991; 151:1389.
- 11 JAMA, 2017; 317(9): 908.
- 12 Circulation. 1970; 42(5): 935.
- 13 Lancet,1968; 2(7577): 1060.
- 14 Lancet, 1972; 2(7782): 835.
- 15 Public Health Nutrition, 2012; 15(2): 254.
- 16 British Medical Journal, 2017; 356: i6699.