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Eating a Bit Less Reduces Heart Attack Risk

The link between obesity and CVD is well known, but an international team has found that, in people only marginally overweight, restricting calorie intake even moderately significantly can reduce heart attack risk.

The study of otherwise healthy, relatively young people has revealed losing just a bit of weight to an optimal level has a disproportionately positive impact. In addition to significantly improving conventional cardiometabolic risk factors, reducing the risk of CVD by about a factor of 13, trial participants enjoyed major improvements on a range of risk factors linked to problems such as type 2 diabetes, stroke, inflammation, and some forms of cancer.

The results are published in the journal Lancet Diabetes & Endocrinology.

The senior author of the study, Luigi Fontana, MD, PhD, commenced the research as an investigator at Washington University in St. Louis, before joining the University of Sydney’s Charles Perkins Centre and Faculty of Medicine and Health last year as the Leonard Ullmann Chair in Translational Metabolic Health and a clinical academic at the Royal Prince Alfred Hospital in Sydney, Australia.

“This is the first time, to our knowledge, that the results of moderate calorie restrictions have been analyzed in nonobese people with clinically normal risk factors,” Fontana says.

“There’s no other drug that can achieve these reductions across all conventional cardiometabolic risk factors that we did—through a marginal reduction in calorie intake while providing all the essential vitamins and minerals with food.”

The randomized controlled two-year Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) study, conducted across three clinics in the United States and coordinated at Duke University, shows outcomes are optimized when weight loss is sustained, with some benefits only observed after one year.

The study notes that the significant reduction achieved across all conventional cardiometabolic risk factors means participants should enjoy the 13-times lower risk of developing CVD than people aged 50 and older with two or more abnormal risk factors, according to previous research.

Fontana says the findings provide further evidence that the trillions of dollars spent every year globally to treat highly prevalent chronic diseases might be better focused on prevention through the implementation of healthful lifestyle practices.

“Modern medicine focuses on diagnosing and treating clinically evident chronic diseases, which are largely preventable, one at a time, mainly with drugs and surgery,” Fontana explains.

“The problem of this approach is that many age-associated chronic diseases—including cardiovascular disease—begin early in life and progress over decades of unhealthy diet and lifestyles, which trigger a wide range of physiologic, metabolic, and molecular alterations deeply influencing the initiation, progression, and prognosis of multiple medical conditions.

“Our study shows that even healthy young and middle-aged people can benefit from focusing on their calorie intake, with indications that, in general, it is important not to delay, and even minor changes at any time of life could make a big difference.

“This should provide an important new tool in fighting the ravages of the 21st-century Western-style lifestyle, with cardiovascular disease continuing to be the leading cause of death and disability worldwide,” Fontana concludes.

The trial of people aged 21–50 drew interest from 10,856 hopeful participants. Ultimately, 117 on the diet and another 75 put in the control group completed the study. Participants on calorie control were fed a healthful diet, with the reduction in abdominal fat being an essential aspect in accounting for the improvements identified in the study.

— Source: University of Sydney