Oct. 20, 2008 -- Globalization hasn't been good on the heart, according to a new study reported in Circulation: Journal of the American Heart Association.
The INTERHEART study, funded by the Canadian Institutes of Health Research, shows that the risk of heart attack crosses geographic boundaries and correlates strongly to the so-called Western diet that favors salty snacks and fried foods, and to a lesser extent, meat.
The risk, spread over five continents, is 30% higher for those who eat a Western diet, the study shows, than for those who adhere to a "prudent diet," or one rich in fruits and vegetables. An Oriental diet, which is high in tofu and other soy products, doesn't seem to lower or raise heart attack risk overall, according to the study.
Researchers out of McMaster University in Ontario, Canada, examined dietary trends among more than 16,000 participants in 52 countries who were recruited between 1999 and 2003. One-third of the participants, or 5,761 people, were interviewed after having a single heart attack; the remaining 10,646 had no known heart disease, including angina, and did not suffer from diabetes, hypertension, or high cholesterol. The mean age of participants was between 53 and 57 years old.
The study categorized eating patterns as Western, Oriental, and prudent. Participants answered written questions and were interviewed by medical personnel about their consumption of 19 food categories, including leafy greens, pickled foods, dairy products, and desserts. All answers were scored according to dietary risk.
The study accounted for other risk factors like smoking, body mass index, age, physical activity, sex, and geographical region in assessing overall heart attack risk. It did not track long-term changes in regional eating habits and their link with health problems.
Researchers concluded that the higher the regular intake of fried and salty foods, the higher the risk of heart attack regardless of which region of the world one resides in; prudent dietary habits carried the lowest risk. An Oriental diet seemed to be protective against heart attack in some regions of the world, but was not the best hedge overall, perhaps because of the high salt content of soy and other sauces common in the dining choices.
"The objective of this study was to understand the modifiable risk factors of heart attacks at a global level," says Salim Yusuf, DPhil, the study's senior author. "This study indicates that the same relationships that are observed in Western countries exist in different regions of the world."
Yusuf is a professor of medicine at McMaster University and is director of the Population Health Research Institute at Hamilton Health Sciences in Ontario, Canada.
The study acknowledges that serving sizes and preparation technique (the type of fat used in cooking, for example) could play a role in increasing heart attack risk in participants adhering to a Western diet.