White vs. brown rice: When it comes to heart disease risk, do grains matter?

  • Coronary artery disease happens when plaque builds up in the blood vessels that supply blood to the heart.
  • Premature coronary artery disease is what it’s called when it develops before a certain age.
  • Lifestyle choices like diet can increase the risk for coronary artery disease.
  • A​ recent study suggests that eating a diet high in refined grains may increase the risk of premature coronary artery disease, while diets high in whole grains may decrease this risk.

The heart pumps blood and nutrients throughout the body, making heart health essential to overall health. Coronary artery disease can contribute to severe heart problems, including heart attacks. Researchers are still examining the risk factors for developing coronary artery disease and how people can take steps to avoid it.

A recent study found that diets high in refined grains, which include white rice, white flour, and white bread, are associated with an increased risk for premature coronary artery disease.

In contrast, they found, diets high in whole grains were associated with a decreased risk for premature coronary artery disease.

The results of the study will be shared at the 13th Emirates Cardiac Society Congress and the American College of Cardiology (ACC) Middle East 2022.

Premature coronary artery disease

Coronary artery disease (CAD) is when the heart arteries don’t carry enough oxygen-rich blood to the heart. It is caused by the build-up of plaque in these critical arteries. It can lead to severe cardiac problems like heart attacks or heart failure.

Premature coronary artery disease (PCAD) has to do with how old someone is when they receive a diagnosis of CAD. This age is not a hard line, with different experts offering various age ranges. For example, researchers in the current study looked at CAD in women ages 70 and younger and men ages 60 and younger.

Cardiologist Dr. Wahaj Aman, who is affiliated with UTHealth Houston Heart & Vascular and Memorial Hermann Katy Hospital but was not involved in the study, explained PCAD to Medical News Today:

“Premature coronary artery disease or early onset coronary artery disease is defined as plaque build-up (atherosclerosis) in arteries of the heart, reducing blood flow in males less than 45 years of age and females less than 55 years of age. Risk factors include diabetes, obesity, hypertension, high cholesterol, and [a] family history of heart disease or [a] family history of very high cholesterol (familial hypercholesterolemia).”

The impact of diet on coronary disease

Diet can play a critical role in heart health and can influence someone’s risk of developing CAD. However, researchers are still working to understand how different foods influence heart health and what dietary recommendations people can follow to best reduce their risk for CAD.

Nutrition specialist Veronica Rouse, who was also not involved in the study, told MNT:

“We are often told what foods to limit or avoid to protect our heart, and that’s because past research focused on nutrients that increased heart disease risk, such as saturated fat and sodium. Newer research approaches healthy eating by researching foods such as vegetables, whole grains, and legumes that will reduce heart disease risk. This makes sense because we eat foods, not nutrients.”

“Our food consumption can definitely impact our cardiac health. Focusing on including more heart-protective foods in one’s diet can help strengthen your heart.”
— Veronica Rouse, dietician

G​rain intake and heart disease risk

Researchers in this current study examined dietary grain intake and the associated risk for premature coronary artery disease. They specifically looked at this risk in the Iranian population.

The study included over 2,000 participants, including 1,369 participants with premature coronary artery disease. These were compared with a control group of 1,168 participants who did not have premature coronary artery disease. Researchers used food frequency questionnaires and dietary assessments to examine participants’ whole grain intake and refined grain intake.

“This is an interesting study comparing refined versus whole grain intake in patients who are at high risk for heart disease. The American Dietary guidelines recommend consuming at least half of total grains as whole grains. Whole grains like brown rice, and quinoa are good examples. Refined grains are processed and have less dietary fiber, iron, and other nutrients,” D​r. Aman said.

Study authors found that diets high in refined grain intake were associated with an increased risk for premature coronary artery disease. On the flip side, diets higher in whole grain intake were associated with a decreased risk of developing premature coronary artery disease.

The data from the study serves as an important reminder of how diet can impact heart health.

Limitations and further research

T​his study had a few limitations. First, the study could not determine cause. The study also looked at PCAD in a unique population, meaning that the results cannot be generalized.

“Diet and disease will always be intricately linked. Dietary studies, unless done very strictly, lead to a lot of confounders [that] are difficult to exclude. This study is a step in the right direction and should encourage everyone, but especially patients with PCAD, to include whole grains in their diet.”
— Dr. Wahaj Aman

Further research can work to confirm the study’s findings, which could lead to updates in dietary recommendations for some people. Individuals can work with their doctors and dieticians to develop a dietary plan based on their unique cardiac needs.

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