Morbidogenic Diet

Harvard University researchers in a 2012 paper reported that processed meat consumption (especially when it is deep fried in trans fats) is associated with a 42 percent higher risk of heart disease.

Enteric microbiome can handle only modest amounts of cold cut sandwiches and save hot dogs so these items must be consumed sparingly no more often than once a week not regularly. Turkey and oily fish (salmon, cod, and tuna), due to their omega-3s are prescribed for generous use.

JAMA Internal Medicine published a paper demonstrating a link between red and processed meat and a higher risk of heart disease and death.

Zhong et al published Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality in JAMA Intern Med. 2020;180(4):503-512. doi:10.1001/jamainternmed.2019.6969 In their meta-cohort study of 29 682 US adults pooled from 6 prospective cohort studies, intake as continuous variables of processed meat, and even unprocessed red meat was significantly associated with a higher incident cardiovascular disease and all-cause mortality, while intake of poultry or fish was not so associated. This study analyzed individual-level data of adult participants in 6 prospective cohort studies in the United States. Baseline diet data from 1985 to 2002 were collected. Participants were followed up until August 31, 2016. Data analyses were performed from March 25, 2019, to November 17, 2019.

Main Outcomes and Measures Hazard ratio (HR) and 30-year absolute risk difference (ARD) for incident CVD (composite end point of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality, based on each additional intake of 2 servings per week for monotonic associations or 2 vs 0 servings per week for nonmonotonic associations.

Results Among the 29 682 participants (mean [SD] age at baseline, 53.7 [15.7] years; 13 168 [44.4%] men; and 9101 [30.7%] self-identified as non-white), 6963 incident CVD events and 8875 all-cause deaths were adjudicated during a median (interquartile range) follow-up of 19.0 (14.1-23.7) years. The associations of processed meat, unprocessed red meat, poultry, or fish intake with incident CVD and all-cause mortality were monotonic (P for nonlinearity ≥ .25), except for the nonmonotonic association between processed meat intake and incident CVD (P for nonlinearity = .006). Intake of processed meat (adjusted HR, 1.07 [95% CI, 1.04-1.11]; adjusted ARD, 1.74% [95% CI, 0.85%-2.63%]), unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.06]; adjusted ARD, 0.62% [95% CI, 0.07%-1.16%]), or poultry (adjusted HR, 1.04 [95% CI, 1.01-1.06]; adjusted ARD, 1.03% [95% CI, 0.36%-1.70%]) was significantly associated with incident CVD. Fish intake was not significantly associated with incident CVD (adjusted HR, 1.00 [95% CI, 0.98-1.02]; adjusted ARD, 0.12% [95% CI, −0.40% to 0.65%]). Intake of processed meat (adjusted HR, 1.03 [95% CI, 1.02-1.05]; adjusted ARD, 0.90% [95% CI, 0.43%-1.38%]) or unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.05]; adjusted ARD, 0.76% [95% CI, 0.19%-1.33%]) was significantly associated with all-cause mortality. Intake of poultry (adjusted HR, 0.99 [95% CI, 0.97-1.02]; adjusted ARD, −0.28% [95% CI, −1.00% to 0.44%]) or fish (adjusted HR, 0.99 [95% CI, 0.97-1.01]; adjusted ARD, −0.34% [95% CI, −0.88% to 0.20%]) was not significantly associated with all-cause mortality.

Conclusions and Relevance These findings suggest that, among US adults, higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with a small increased risk of incident CVD, whereas higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality. These findings have important public health implications and should warrant further investigations.

Micha et al published Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type 2 Diabetes – An Updated Review of the Evidence in Current Atherosclerosis Reports Dec 2012; 14(6): 515–524 doi:10.1007/s11883-012-0282-8

Growing evidence suggests that effects of red meat consumption on coronary heart disease (CHD) and type 2 diabetes could vary depending on processing. We reviewed the evidence for effects of unprocessed (fresh/frozen) red and processed (using sodium/other preservatives) meat consumption on CHD and diabetes. In meta-analyses of prospective cohorts, higher risk of CHD is seen with processed meat consumption (RR per 50 g: 1.42, 95 %CI = 1.07–1.89), but a smaller increase or no risk is seen with unprocessed meat consumption. Differences in sodium content (~400 % higher in processed meat) appear to account for about two-thirds of this risk difference. In similar analyses, both unprocessed red and processed meat consumption are associated with incident diabetes, with higher risk per g of processed (RR per 50 g: 1.51, 95 %CI = 1.25–1.83) versus unprocessed (RR per 100 g: 1.19, 95 % CI = 1.04–1.37) meats. Contents of heme iron and dietary cholesterol may partly account for these associations. The overall findings suggest that neither unprocessed red nor processed meat consumption is beneficial for cardiometabolic health, and that clinical and public health guidance should especially prioritize reducing processed meat consumption.

Refined and processed grains (white flour or white rice etc.) are glycemogenic - i.e. they induce a very sharp elevation of blood sugar and insulin – and as the levels of blood sugar and insulin sharply drop an hour or so later, it impedes satiety and promotes caloric and nitrogen overloading.

A 2017 study in the found that refined grain flour intake was associated with a 9.4 percent higher risk of heart disease.

Chen et al published Dietary refined grain intake could increase the coronary heart disease risk: evidence from a meta-analysis in International Journal of Clinical and Experimental Medicine 2017;10(8):12749-12755 www.ijcem.com /ISSN:1940-5901/IJCEM0051130

Previous reports have suggested a potential association of dietary refined grain intake with the risk of coronary heart disease (CHD). Since such association is controversial, we conducted a meta-analysis to re-assess the relationship between dietary refined grain intake and the risk of CHD. Methods: The databases of Pubmed, Embase, Web of science and Medline were carefully searched until 30th of Sep in 2016, without limits of language and publication year. Odds Ratios (OR) with 95% Confidence Intervals (CI) was derived by using random effects models. Quality assessment was conducted according to Newcastle-Ottawa-Scale (NOS), and analysis of the statistical heterogeneity using I2. Results: Our study was based on 8 articles with 12 studies, involving 8059 CHD cases. The total OR (95% CI) of CHD risk for the highest vs. the lowest categories of refined grain intake was 1.094 (1.007-1.189), with no heterogeneity among studies (I2 = 0.0%, P = 0.508). The average NOS score was 7.1, suggesting a high quality. And there was no publication bias (P = 0.17) of the meta-analysis about dietary refined grain intake and CHD risk. Subgroup analyses showed that higher dietary refined grain intake could increase the risk of CHD in all subgroups examined except in male populations and the disease outcome of myocardial infarction (MI). Conclusion: We found that higher dietary refined grain intake can significantly increase the risk of CHD. LESS

Deep fried starches and meats

Steaming, baking, broiling, roasting and stir-fry are safer than deep-frying,

Two American observational studies found that regular habitual consumption of deep fried foods increases the risk of death from heart disease.

Cahill, et al published Fried-food consumption and risk of type 2 diabetes and coronary artery disease: a prospective study in 2 cohorts of US women and men in American Journal of Clinical Nutrition, Aug 2014; 100 (2) : 667–675, https://doi.org/10.3945/ajcn.114.084129; concluding that fairly frequent fried-food consumption tends to be associated with risk of incidence of metabolic syndrome elements like diabesity obesity, hypertension and hypercholesterolemia and coronary artery disease, such that habitual fried food consumption operates as a precursor to coronary artery disease. Through the processes of oxidation, polymerization, and hydrogenation, the cooking method of frying modifies both foods and their frying medium. However, it remains unknown whether the frequent consumption of fried foods is related to long-term cardiometabolic health. Authors examined fried-food consumption and risk of developing incident type 2 diabetes (T2D) or coronary artery disease (CAD). Fried-food consumption was assessed by using a questionnaire in 70,842 women from the Nurses’ Health Study (1984–2010) and 40,789 men from the Health Professionals Follow-Up Study (1986–2010) who were free of diabetes, cardiovascular disease, and cancer at baseline. Time-dependent Cox proportional hazards models were used to estimate RRs and 95% CIs for T2D and CAD adjusted for demographic, diet, lifestyle, and other cardiometabolic risk factors. Results were pooled by using an inverse variance–weighted random-effects meta-analysis. We documented 10,323 incident T2D cases and 5778 incident CAD cases. Multivariate-adjusted RRs (95% CIs) for individuals who consumed fried foods <1, 1–3, 4–6, or ≥7 times/wk were 1.00 (reference), 1.15 (0.97, 1.35), 1.39 (1.30, 1.49), and 1.55 (1.32, 1.83), respectively, for T2D and 1.00 (reference), 1.06 (0.98, 1.15), 1.23 (1.14, 1.33), and 1.21 (1.06, 1.39), respectively, for CAD. Associations were largely attenuated when we further controlled for biennially updated hypertension, hypercholesterolemia, and body mass index.

Fried food consumption over 3 times a week or more often than on alternative days is associated with a higher risk of developing metabolic syndrome (type 2 diabetes, obesity and hypertension etc.) via dysbiosis-inflammaging duo.

Gadiraju et al published Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence in Nutrients Oct 2015;7(10):8424-30. doi: 10.3390/nu7105404. DOI: 10.3390/nu7105404

Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week). Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying), temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

Sugar-sweetened sodas and beverages, fruit juices, sherbets fruit flavoured drinks punch etc. The dysbiosis-inflammaging morbidity generating impact of sugar solutions is mediated through glycemiogensis with sugar-insulin spikes that eventually elevate triglyceride levels. Diet rich in sugar solutions is far more potent precursor of hypertriglyceridemia than high fat content diets especially among those cohorts who have not evolved consuming high fat diet.

Untreated high triglyceride levels may increase the risk of heart attack and stroke, according to

National Heart, Lung, and Blood Institute at National Health Institute online advisory for management of hypertriglyceridemia or dyslipidemia, characterized by an elevated triglyceride level recommends adopting a heart-healthy lifestyle changes, starting with seriously limiting alcohol, shunning sugars, and limiting dietary saturated or trans fats; increasing food items rich in omega-3 fatty acids, getting regular physical activity; quitting smoking; and aiming for a healthy weight by slimming down and building muscle mass. Refractory cases might require prescriptions of fibrates, nicotinic acid, or statins to address the very high triglyceride levels refractory to lifestyle revision. Prevention is far more desirable.

Individuals who ingest over 25% of their daily calories from simple sugar (hexoses and disaccharides) double their cardiovascular mortality risk. Optimal fraction of caloric sourcing from simple sugars should be below 10% and better yet below 5% which comes to less than 8-10 sugar cubes or teaspoons of sugar or 40-50 gm or 160-200 calories based on an average 2000-2400 a day caloric intake.

Yang et al published Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults in JAMA Internal Medicine 2014;174(4):516-524. doi:10.1001/jamainternmed.2013.13563 and using a prospective cohort of a US adults the authors demonstrated an association of sugar consumption with cardiac mortality consumption of sugar added to foods adding that sweetened beverages exceeding 10% of total daily caloric intake poses a substantial risk adding that a vast majority of American adults consume a lot more added sugar than that can be tolerated such that sugar consumption operates as a precursor to cardiac mortality.

To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality. Design, Setting, and Participants National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31 147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study.

Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P < .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163 039 person-years. Age-, sex-, and race/ethnicity–adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index.

Consumption of added sugar, including all sugars added in processing or preparing foods, among Americans aged 2 years or older increased from an average of 235 calories per day in 1977-1978 to 318 calories per day in 1994-1996. This change was mainly attributed to the increased consumption of sugar-sweetened beverages.1 Although the absolute and percentage of daily calories derived from added sugars declined between 1999-2000 and 2007-2008, consumption of added sugars remained high in US diets, especially among children.2 Recommendations for added sugar consumption vary substantially. The Institute of Medicine recommends that added sugar make up less than 25% of total calories,3 whereas the World Health Organization recommends less than 10%.4 The American Heart Association recommends limiting added sugars to less than 100 calories daily for women and 150 calories daily for men.5 The 2010 Dietary Guidelines for Americans6 recommend limiting total intake of discretionary calories, which include added sugars and solid fats, to 5% to 15% of daily caloric intake. Randomized clinical trials and epidemiologic studies have shown that individuals who consume higher amounts of added sugar, especially sugar-sweetened beverages, tend to gain more weight7 and have a higher risk of obesity,2,8-13 type 2 diabetes mellitus,8,14-17 dyslipidemias,18,19 hypertension,20,21 and cardiovascular disease (CVD).14,22 Most previous studies have focused on sugar-sweetened beverages but not total added sugar, and none of these studies has used nationally representative samples to examine the relationship between added sugar intake and CVD mortality.

Abundant Amounts of Alcohol

binge drinking warning signs

Some studies—like that in Alcohol Research & Health—suggest that moderate drinkers are at a lower risk of heart disease compared to heavy drinkers and non-drinkers.

https://pubs.niaaa.nih.gov/publications/arh23-1/15-24.pdf

Arthur Klatsky, in an National Institute of Health online advisory from National Institute on Alcohol Abuse and Alcoholism entitled Moderate Drinking and Reduced Risk of Heart Disease

Although heavier drinkers are at increased risk for some heart diseases, moderate drinkers are at lower risk for the most common form of heart disease, coronary artery disease (CAD) than are either heavier drinkers or abstainers. This association has been demonstrated in large-scale epidemiological studies from many countries. Abstainers may share traits potentially related to CAD risk, such as psychological characteristics, dietary habits, and physical exercise patterns. However, evidence supports a direct protective effect of alcohol, even after data have been adjusted for the presence of these factors. The alcohol-CAD relationship is also independent of the hypothetically increased risk status among abstainers who stopped drinking for medical reasons. All alcoholic beverages protect against CAD, although some additional protection may be attributable to personal traits or drinking patterns among people who share some beverage preferences or to nonalcohol ingredients in specific beverages. Alcohol’s protective effect may result from favorable alterations in blood chemistry and the prevention of clot formation in arteries that deliver blood to the heart muscle. Because CAD accounts for a large proportion of total mortality, the risk of death from all causes is slightly lower among moderate drinkers than among abstainers, but heavier drinkers are at considerably higher total mortality risk

The American Heart Association (AHA) recommends limiting to just one alcoholic drink a day for women and a maximum of two for men.

Salt preserved canned soups and vegetables

While some canned soups and vegetables are exception to this but many are high in sodium (salt) and even fat, Sodium bicarbonate or sodium chloride among several other chemicals are added as a to increase shelf life and palatability the latter to promote sales by triggering a low-grade addition for the tasty food items. American Heart Association (AHA) recommends limiting daily sodium intake to below 3 gm per day for adult while half as much (1,500 mg) is even more desirable, especially those with elevated blood pressure. Most Americans daily consume over 5 g of sodium. It is possible to include canned foods into meals without exceeding the permitted sodium intake by choosing, ‘low-sodium,’ or ‘low salt,’ or ‘no added salt,’ products and by draining away and discarding the water in which the edible solid products are preserved. The products can even be washed with tap water in addition.

Foods containing trans fats

Artificial trans fats inflict adverse health impacts by lowering the HDL, or ‘good’ cholesterol levels and raise LDL or in the ended shifting their ration which realises increase the risk for heart disease and stroke etc.

Habitual trans fat consumption is precursor for cardiovascular morbidity and mortality.

Mozaffarian et al published a study of 80,000 women Trans Fatty Acids and Cardiovascular Disease in New England Journal of Medicine, Apr 2006 13;354(15):1601-13. doi: 10.1056/NEJMra054035.

The intake of trans fat has been associated with coronary heart disease, sudden death from cardiac causes, and diabetes. This article reviews the evidence for physiological and cellular effects of trans fatty acids, unsaturated fatty acids with at least one double bond in the trans configuration. The authors consider the feasibility and potential implications of reducing or eliminating the consumption of trans fatty acids from partially hydrogenated vegetable oils in the United States.

FDA notes that food containing less than 0.5 grams of trans fats, sometimes listed on the ingredient label as partially hydrogenated oils, can claim they have no trans fats.

Non-dairy coffee creamers, microwave popcorns, frozen doughs, pastries, pizzas, fried foods and shortenings could contain trans fats despite a prohibition against ales of trans fat tainted foods if they were produced prior to the transition and ban.

Sugared & salty sandwich and hotdog condiments used as toppings or salad dressings. Given that it is habitual and traditional to include generous amounts of condiments and salad dressings when consuming traditional Western diet of hamburgers, hotdogs etc., the practical approach would require a shift toward Mediterranean diet.

Choi, et al published Comparison of Health Outcomes Among High- and Low-Income Adults Aged 55 to 64 Years in the US vs England in JAMA Internal Medicine. Jul 2020;180(9):1185-1193. doi:10.1001/jamainternmed.2020.2802 undertaking research to evaluate the difference in health status between high- and low-income individuals in the US vs England and concluding that for most health outcomes examined in this cross-sectional study, the health gap between adults with low vs high income appeared to be larger in the US than in England, and the health disadvantages in the US compared with England are apparently more pronounced among individuals with low income. Public policy and public health interventions aimed at improving the health of adults with lower income should be a priority in the US. In their cross-sectional study including 18 572 persons (46 887 person-years of observations), the health gap between the bottom 20% and top 20% of income distribution was significantly greater for US adults aged 55 to 64 years than their English peers on 13 of 16 health measures. In addition, for most measures, the health of US adults appeared to be poorer than that of their peers in England, especially those from the lower end of the income distribution. The results were derived using data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) for 2008-2016, a pooled cross-sectional analysis of comparably measured health outcomes, with adjustment for demographic characteristics and socioeconomic status, was conducted. The analysis sample included community-dwelling adults aged 55 to 64 years from the HRS and ELSA, resulting in 46 887 person-years of observations. Data analysis was conducted from September 17, 2019, to May 12, 2020.

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