Study Links Americans' Low Fiber Intake to Higher Heart Risk

FRIDAY, Oct. 25 (HealthDay News) -- People who don't eat enough fiber seem at increased risk for heart problems, and too few Americans are consuming enough fiber, a new study says.

Researchers analyzed data collected from more than 23,000 U.S. adults between 1999 and 2010 and found that low fiber intake was strongly associated with heart disease risk factors such as obesity, inflammation and metabolic syndrome. The syndrome is a group of symptoms that puts people at increased risk for diabetes and heart disease.

Previous studies have found that dietary fiber may help lower blood pressure, cholesterol levels and inflammation. Despite those findings, this new study found that Americans don't have enough fiber in their diets.

Fiber-rich foods include fruits, vegetables, legumes and grains.

The Institute of Medicine -- an independent nonprofit organization that advises the U.S. government on health issues -- recommends 38 grams of fiber a day for men aged 19 to 50 and 30 grams a day for men over 50. The IOM recommends 25 grams a day for women aged 19 to 50 and 21 grams a day for women over 50.

But the average dietary fiber intake among the study participants was only about 16 grams per day, according to the study, which was published in the December issue of the American Journal of Medicine.

The new findings show the need to develop new strategies and polices to increase Americans' dietary fiber intake, study senior investigator Dr. Cheryl Clark, of the Center for Community Health and Health Equity at Brigham and Women's Hospital and Harvard Medical School, said in a journal news release.

The researchers also found racial and ethnic differences. Compared to whites, Mexican-Americans had higher levels of fiber in their diet, while blacks had lower levels.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: The American Journal of Medicine, Oct. 18, 2013

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Study Compares Heart Risks for 2 Hormonal Regimens

WEDNESDAY, Oct. 2 (HealthDay News) -- An estrogen drug used by women to relieve hot flashes and other menopausal symptoms is tied to an increased risk for certain types of heart troubles, while another estrogen drug appears to be safer, a new study says.

Researchers compared the cardiovascular safety of the two commonly used pills: Premarin, a so-called "conjugated equine estrogen" and a generic version of estradiol.

Premarin is made from the urine of pregnant mares while estradiol is a "natural" or "bioequivalent" estrogen, according to background information in the study, which was funded by the U.S. National Heart, Lung, and Blood Institute.

Although these estrogen pills "are effective for managing menopause symptoms, not enough is known about the cardiovascular safety of different oral hormone therapy products relative to each other," lead author Nicholas Smith, an affiliate investigator at the Group Health Research Institute, said in a Group Health news release.

The researchers tracked outcomes for 384 postmenopausal women, aged 30 to 79, who were using hormone therapy pills. The women included 68 who had experienced blood clots in the legs and in the lungs, 67 who had a heart attack, as well as 48 who had an ischemic stroke, which occurs due to blocked blood flow to the brain. The other 201 women acted as a control group.

Compared to women who took estradiol, those who took Premarin had a higher risk of blood clots. The women taking Premarin also had a somewhat higher risk of heart attack. There was no difference in ischemic stroke risk, according to the study published online this week in the journal JAMA Internal Medicine.

Smith and his colleagues said that further studies are needed to confirm these findings.

"If confirmed, the results would provide valuable information to women and their health care professionals when making safety decisions regarding available (hormone therapy) options for menopausal symptom management," the researchers concluded.

One other expert agreed that this "small" study is not the final word on this issue.

"Clearly, further studies need to be done, as for many women HRT is part of the treatment for quality of life, and knowing the safest treatment option is crucial," said Dr. Suzanne Steinbaum, director for women and heart disease at Lenox Hill Hospital, in New York City.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Suzanne Steinbaum, M.D., director, women and heart disease, Lenox Hill Hospital, New York City; Group Health Research Institute, JAMA Internal Medicine, news releases, Sept. 30, 2013

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Heart Attack Symptoms Women Need to Know

Chest pain, shortness of breath, dizziness. Those are the well-known signs of heart attack. But what about the not so obvious signs?

Many women experience heart attacks differently then men, and knowing the subtle differences may one day save your life.

According to Radha Kachhy, MD, a cardiologist with Duke Cardiology of Raleigh, women are less likely to experience the crushing chest pain that some men describe as an elephant sitting on their chest. Instead, they may feel a persistent pain in their back, neck, jaw or even in their shoulder blades.

“Where the pain is located is not as important as when it occurs,” explains Dr. Kachhy.  “If it happens during times of exertion, it should be taken seriously. One of my patients said her shoulder hurt every time she walked. She thought it was her purse, but her shoulder throbbed when she wasn’t holding her purse.”

Women are also more likely to experience fatigue, sweating and nausea, as well as indigestion they might mistake for heartburn. “What you are doing when you experience these symptoms makes a difference. If you feel what you think is heartburn while walking, chances are good it may not be indigestion.”

Symptoms of heart attack can also occur when you are resting.  It’s important to know your body’s signals. “If you feel like you just finished a triathlon but you haven’t moved, take notice,” she advises.

Because more women are likely to brush off their symptoms or delay seeking treatment, they are often their own worst enemy. “I have patients who experienced symptoms of a heart attack and said, ‘well, I decided to do the laundry. When it didn’t get better, I went to the doctor,’” Kacchy said.

“Time is muscle,” she stressed. “If someone is having a heart attack, we want him or her to be evaluated as quickly as possible.”

The best way for women to arm themselves against heart disease and heart attack is to take steps to prevent it. “Know your numbers,” says Kachhy, meaning your blood pressure, your blood glucose, your cholesterol and your body mass index or BMI.  If you know you carry some risks for heart disease, if you smoke or are overweight, make lifestyle changes with your diet and exercise to lower that risk.

Also, familiarize yourself with the signs of heart attack – both for yourself and your loved ones.

Women who believe they are having a heart attack, or anyone who experiences severe chest pain should call 911.  “If you experience mild discomfort for weeks, make an appointment to see your doctor.

“The longer you wait, the more heart muscle damage that can be done,” Kachhy said.

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