A woman who is physically active, eats healthily, drinks in moderation, does not smoke, and maintains a healthy weight has a substantially lower risk of heart attack, says a report in Archives of Internal Medicine (JAMA/Archives), October 22 issue.

The authors explain "Coronary heart disease is the most important cause of death and disability in women. Despite a lower incidence in women, coronary heart disease-related mortality and the percentage of sudden deaths from coronary heart disease without previous symptoms is higher and the trend of decline in incidence is slower than in men."

Agneta Akesson, Ph.D., M.P.H., Karolinska Institutet, Stockholm, and team looked at the eating habits of 24,444 postmenopausal women by looking at food frequency questionnaires. These questionnaires indicated how often these women consumed 96 common foods.

The researchers wrote "We derived four major dietary patterns: 'healthy' (vegetables, fruits and legumes) , 'Western/Swedish' (red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes and fish), 'alcohol' (wine, liquor, beer and some snacks) and 'sweets' (sweet baked goods, candy, chocolate, jam and ice cream) ."

The women also gave information regarding their family history, health status, education, medication use, body measurements, and physical activity. Over an average 6.2 years follow-up, 308 of them had a heart attack, 51 of which were fatal. Two diet types were linked to a lower heart attack risk - they were 'healthy' and 'alcohol' types.

The scientists wrote "The low-risk diet (high scores for the healthy dietary pattern) characterized by a high intake of vegetables, fruit, whole grains, fish and legumes, in combination with moderate alcohol consumption (5 grams of alcohol per day or less) , along with the three low-risk lifestyle behaviors (not smoking, having a waist-hip ratio of less than the 75th percentile and being physically active) , was associated with 92 percent decreased risk compared with findings in women without any low-risk diet and lifestyle factors. This combination of healthy behaviors, present in 5 percent, may prevent 77 percent of myocardial infarctions in the study population."

The scientists note that many components of fruit, vegetables and whole grains, including fiber, antioxidant vitamins and minerals, have been linked to a lower risk of coronary heart disease. Previous studies had also found that small quantities of alcohol helped prevent the accumulation of plaque in the arteries, which further help stave off heart attacks.

The concluded "Our study findings indicate that healthy dietary behaviors are present in the population. These dietary behaviors together with a healthy lifestyle and body weight may prevent most myocardial infarction events."

"Combined Effect of Low-Risk Dietary and Lifestyle Behaviors in Primary Prevention of Myocardial Infarction in Women"
Agneta Akesson, PhD, MPH; Christoph Weismayer, PhD; P. K. Newby, ScD, MPH, MS; Alicja Wolk, DMSc
Arch Intern Med. 2007;167:2122-2127.
Click here to view abstract online

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