What grains you eat can affect your risk of early heart disease

In one of the first studies to examine the relationship between different types of grain consumption and premature coronary disease in the Middle East, researchers found that a higher consumption of refined grains was associated with an increased risk of premature coronary disease in the Iranian population, while consumption of whole grains was is associated with reduced risk. The study will be presented at the American College of Cardiology (ACC) Middle East 2022 in conjunction with the 13th Emirates Society of Cardiology Congress, which will be held in Dubai, United Arab Emirates, October 7-9, 2022.

According to the researchers, previous epidemiological studies have reported an association between different types of grain consumption and the risk of coronary heart disease. The current study evaluated the association between refined and whole grain consumption and the risk of PCAD in an Iranian population.

Premature coronary artery disease (PCAD) refers to atherosclerotic narrowing of the coronary arteries in men under the age of 55 or in women under the age of 65. It is often asymptomatic in the early stages of the disease, but can lead to chest pain (angina) and/or heart attack with progressive narrowing (stenosis) or rupture of the arterial wall. Risk factors for PCAD include smoking, high cholesterol, high blood pressure, and diabetes.

“There are many factors that go into why people may consume more refined grains as opposed to whole grains, and these cases vary from person to person, but some of the most important factors to consider include the economy and income, employment, education, culture, age and other such factors,” said Mohammad Amin Hajawi Gaskarei, MD, of Isfahan Cardiovascular Research Center and Cardiovascular Research Institute at Isfahan University of Medical Sciences in Isfahan, Iran, and lead author of the study. “Diet, which includes large amounts of unhealthy and refined grains, can be considered similar to a diet high in harmful sugar and oil.’

Whole grains are defined as those that contain whole grains, while refined grains are milled — ground into flour or meal — to improve shelf life, but they lose important nutrients in the process. 2019 ACC/American Heart Association Guidelines for primary prevention of cardiovascular diseases recommends a diet that emphasizes the consumption of vegetables, fruits, legumes, whole grains, and fish to reduce heart disease risk factors.

The study recruited 2099 individuals with PCAD from hospitals with catheterization laboratories in different cities and ethnic groups across Iran who underwent coronary angiography (women aged ≤ 70 and men aged ≤ 60). A total of 1168 patients with normal coronary arteries were included in the control group, while 1369 patients with CAD with obstruction equal to or greater than 75% in at least one coronary artery or ≥ 50% in the left main coronary artery were group of cases. .

Participants were given a food frequency questionnaire to assess dietary patterns and the association between whole grain and refined grain intake and PCAD risk in people without previous heart disease diagnoses. After adjustment for confounding factors, higher consumption of refined grains was associated with an increased risk of PCAD, while consumption of whole grains was inversely associated with a decreased risk of PCAD.

“As more and more studies show the increase in consumption of refined grains worldwide, as well as the impact on overall health, it is important that we find ways to encourage and educate people about the benefits of eating whole grains,” said Hajjawi Gascarei. “Tactics to consider include teaching about better dietary choices in schools and other public settings in plain language that the public can understand, as well as through television programs and continuing high-level research presented at medical conferences and published in medical journals. Clinicians also need to have these conversations with each other and with their patients.”