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CMHC PULSE

Cardio Metabolic Health Congress – Official Blog

Heart Health Benefits of Nuts

A growing amount of recent research indicates that consumption of nuts can reduce the risk of cardiovascular disease: as nuts contain unsaturated fatty acids, fiber, protein, vitamin E, folate, and several minerals, such as potassium, zinc, and magnesium—and boast additional bioactive chemicals, including phenolics and phytosterols. New findings published in Circulation Research, a journal part of the American Heart Association, suggests that eating more nuts can specifically help heart health among people with type 2 diabetes.

The researchers found that any nut consumption delivered benefits; tree nuts demonstrated the strongest association, but even a small amount of nuts produced an effect. The findings indicated that eating five weekly servings of nuts had a 17 percent lower risk of total cardiovascular disease incidence, compared to people with type 2 diabetes who did not consume many nuts. Moreover, there was a 20 percent lower risk of coronary heart disease, a 34 percent lower risk of cardiovascular disease death, and a 31 percent reduced risk of all-caused mortality.

When compared to people who did not make any significant changes in nut-eating habits after a diagnosis of diabetes, those who increased their intake of nuts had an 11 percent lower risk of cardiovascular disease, a 15 percent lower risk of coronary heart disease, a 25 percent lower risk of cardiovascular disease death, and a 27 percent lower risk of all-cause premature death.

A previous 2016 study in the British Medical Journal reinforced the assertion that “higher nut consumption is associated with a lower risk of all-cause mortality, total CVD, CVD mortality, total CHD, CHD mortality and sudden cardiac death.” Another 2017 study published in the Journal of the American College of Cardiology reported that diabetes risk drops by 40 percent with only 20 grams of nuts each day, and the risk of infectious diseases is lowered by 75 percent.

Notwithstanding the fact that most of the findings stemmed from observational studies with limited sample sizes, a systematic review of clinical trials spanning the last 25 years has confirmed that nuts can indeed benefit cardiovascular health, optimize the aging process, and minimize the risk of stroke and coronary heart disease. While the exact biological mechanisms of nuts regarding heart health remain unclear, but scientists assert that nuts can improve blood pressure and blood sugar control, metabolism of fats, inflammation and blood vessel wall function.

The Importance of Women’s Cardiovascular Health

February is not only designated as American Heart Month, it is also recognized as a month to commemorate women’s cardiovascular disease: the number one cause of death among females. Statistics indicate that women are twice as likely to die from cardiovascular disease than they are from breast cancer, and up to 40% of all premature deaths before the age of 75 occur due to cardiovascular disease. A recent article in Medscape notes that despite these recognized findings, women’s heart disease is often under-recognized and under-treated—and women are less likely to receive appropriate, timely, evidence-based treatments.

Erin Michos, a cardiologist at Johns Hopkins School of Medicine, outlines reasons surrounding why women with CVD often experience ‘suboptimal’ care. Having worked on a recently published study in the Journal of the American Heart Association titled “Gender Differences in Patient-Reported Outcomes Among Adults with Atherosclerotic Cardiovascular Disease,” the data ultimately concluded that women with ASCVD were more likely to report poorer patient experience, lower health-related quality of life, and poorer perception of their health when compared with men. 1 in 4 women reported “dissatisfaction with their healthcare experience,” in addition to “poor communication with providers”—additionally noting that doctors did not fully listen to them.

Professor of cardiology at Keele University Mamas Mamas notes that the higher risks of CVD among women may begin at a much younger age; division chief of cardiology at the University of Arizona, Dr. Martha Gulati, focuses on factors including certain high-risk pregnancies. Dr. Gulati notes that while clinicians often look at ‘traditional risk scores,” physicians are often not discussing future cardiovascular risk with female patients: given that hypertension, and diabetes, often resolve during pregnancy. Dr. Gulati states that “we really need to be screening for these adverse pregnancy outcomes when they occur, informing them about their future cardiovascular risk.” The University of Arizona has created new resources and guidelines titled Heart to Heart to specifically educate women on their ‘risk-enhancing factors,’ in order to properly address overall cardiovascular risk.

Additional gaps in female care include women with breast cancer, all of whom are at a higher risk of cardiovascular disease, in addition to women with rheumatological disorders: including rheumatoid arthritis and lupus. Women with HIV are also diagnosed with heart disease at higher rates; moreover, younger women continue to remain a high-risk group. Lastly, Dr. Annabel Volgman, professor of Medicine at the Rush Medical Center in Chicago, notes the ways in which women have worse cardiovascular risk factor profiles than men. Women often present with different forms of heart disease, often having microvascular disease instead of obstructive coronary artery disease. Women can also have heart attacks ‘triggered by emotional events,’ termed stress cardiomyopathy.

Given the striking disparities in women’s cardiovascular health, it is critical to further investigate the reasons behind the inequalities. All of the aforementioned findings have important implications in the realm of public health, and collectively require additional research towards understanding the gender-specific differences in the quality, delivery, and outcomes in healthcare. Attend our CMHC West Women’s Health Summit: Navigating Female Cardiometabolic Care for the latest clinical research in women’s cardiometabolic health, and hands-on strategies to implement effective approaches into practice.