A symposium of top UK cardiologists and international heart experts last week confirmed the key role of diet in reducing the burden of coronary heart disease (CHD). They said that the health care profession needed to push diet up the agenda, and presented data showing the benefits of several functional foods in research.
The conference, at the Royal Society of Medicine in London, singled out foods such as plant sterols and omega-3 fatty acids as specific tools in the fight against heart disease.
Dr Andrew Neil from the Institute of Health Sciences at the University of Oxford outlined the wealth of clinical evidence for the efficacy of plant sterols and stanols. He said that plant sterols in spreads can lower cholesterol by up to 15 per cent. Plant sterols work in a different way to statins and therefore have an additive, complimentary effect.
"If sterols and stanols were used widely we might predict a 20 per cent reduction in CHD events across the population," added Dr Neil.
Nicholas Wald, of the Wolfson Institute of Preventive Medicine, pointed to recent research which shows that homocysteine is a causal risk factor for CHD and stroke, and not merely a marker for the diseases. He noted that conventional randomised trials of homocysteine and cardiovascular disease are in progress but individual trials may not be large enough to show the expected effect. However, the new evidence supported the case for folic acid fortification of food; this would help prevent cardiovascular disease as well as the birth defect spina bifida, said Wald.
Tom Sanders from Kings College London outlined the evidence from population studies and clinical trials showing that omega-3 oils dramatically reduce the risk of sudden cardiac death. He discussed the mechanisms involved, which do not involve effects on blood cholesterol, and suggested that the evidence pointed to a mechanism which involved omega-3 fatty acids protecting the heart from dangerous heart rhythms.
Sanders predicted that as fish stocks are threatened, the use of plant-based omega-3 oils will become more widespread in future.
The speakers agreed that the role of diet in managing heart health issues is underused by the clinical professions and that this may be because doctors and others do not receive enough training in nutrition issues. Luci Daniels, delegate and chair of the British Dietetic Association, suggested that the medical professions approach dietitians and work with them to develop training and guidelines.
Speaker Professor Neil Poulter of Imperial College London added: "Doctors just aren't given the training in diet and without this they will not be able to give patients effective dietary advice. Therefore a nutritional element [to the curriculum] and a greater emphasis on diet in their surgeries is vital."
The symposium 'The Heart: Foods for thought…and function' took place on 21 January 2003 at the Royal Society of Medicine, London. It was sponsored by Unilever's Flora pro.activ.
Other speakers included Prof. Christine Williams (optimal diet), Dr Michael de Lorgeril (Lyons diet), Dr Malcolm Law (epidemiology) and Prof. Cesare Sirtori (soya).