How to reduce the risk of life-threatening complications

By Liz Meszaros, MDLinx
Published August 20, 2019

Key Takeaways

Can you reduce your risks of cardiovascular disease (CVD), cardiovascular events, depression, cancer, and even death? The answer is "yes," and may involve some simple lifestyle changes that can be as easy as eating dark chocolate regularly. How hard is that?

As the research stacks up, here is a look at some studies that may offer some insight into how to reduce your risks of many serious and potentially deadly conditions. All recently published, each study includes thousands of patients, most with long-term follow-up.

Eat a plant-based diet

According to research published in the Journal of the American Heart Association, strict adherence to a plant-based diet may lower your risks of CVD, all-cause mortality, and CVD-related mortality.

In this analysis, over 12,000 middle-aged adults taken from the Atherosclerosis Risk in Communities (ARIC) study were followed from 1987 through 2016. Compared with those in the lowest quintile of adherence to an overall plant-based or pro-vegetarian diet, participants in the highest quintile of adherence demonstrated impressive reductions in a number of threatening conditions: a 16% lower risk of CVD, a 31%-32% lower risk of CVD mortality, and an 18%-25% lower risk of all-cause mortality (all P < 0.05 for trend). Higher adherence to a plant-based diet was also associated with a 19% lower risk of CVD mortality and an 11% lower risk of all-cause mortality.

"[D]iets consisting of predominantly plant foods and that are lower in animal foods were associated with a lower risk of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality in a general population. Dietary patterns that are relatively higher in plant foods and relatively lower in animal foods may confer benefits for cardiovascular health," concluded the authors.

Get your BP under control

Higher nighttime and 24-hour BP may increase your risk of CV events and CV mortality, according to a study recently published in JAMA.

In this longitudinal, population-based trial, researchers included over 11,000 adults (mean age: 54.7 years; 49.3% women) from Europe, Asia, and South America, who were followed from May 1988 through October 2016. For nighttime systolic BP level, the HR for total mortality was 1.23 (95% CI: 1.17-1.28), and for CV events, 1.36 (95% CI: 1.30-1.43). For 24-hour systolic BP level, they were 1.22 (95% CI: 1.16-1.28) and 1.45 (95% CI: 1.37-1.54), respectively.

"In this population-based cohort study, higher 24-hour and nighttime blood pressure measurements were significantly associated with greater risks of death and a composite CV outcome, even after adjusting for other office-based or ambulatory blood pressure measurements. Thus, 24-hour and nighttime blood pressure may be considered optimal measurements for estimating CV risk, although statistically, model improvement compared with other blood pressure indexes was small," these researchers concluded.

Get your weight under control

High BMI and waist circumference increase mortality risk. In this study conducted in two Mexico City districts, researchers included over 115,000 adults (mean BMI: 28.0 kg/m2 in men, 29.6 kg/m2 in women) aged 35 years or older who were followed for up to 14 years. In adults with a BMI of over 25 kg/m2, for every 5-kg/m2 increase in BMI, researchers found a 30% increased risk for all-cause mortality. And these risks were greater in younger adults compared with older ones. Participants aged 40 to 60 years had a 40% greater risk, while those who were older (60-74 years) had only a 24% increased risk.

Eat dark chocolate

Eating dark chocolate may reduce your risk of developing symptoms of depression. In a recent study published in Depression & Anxiety, researchers analyzed data from over 13,000 adults aged 20 years or older who were enrolled in the National Health and Nutrition Examination Survey (NHANES). They found that—compared with those who ate non-dark chocolate—people who ate dark chocolate had a lower risk of depressive symptoms (OR: 0.30; 95% CI: 0.21-0.72). Those who ate the most chocolate had a 57% lower risk of such symptoms (OR: 0.43; 95% CI: 0.19-0.96) compared with those who didn't eat any chocolate.

Eat foods that are rich in flavonoids

Flavonoid-rich foods—like apples and tea—may protect against cancer and CVD, especially if you are a smoker or a heavy drinker. Researchers analyzed data from the Danish Diet, Cancer and Health cohort from over 56,000 Danes, who were followed for 23 years. Those who regularly ate moderate-to-high quantities of foods rich in flavonoids—polyphenolic compounds found in plant-derived foods and beverages including fruits, vegetables, dark chocolate, tea, and red wine—were less likely to die from either cancer or heart disease. The risk reduction was greatest in those who were at highest risk for chronic disease because of smoking or excessive drinking.

"It's important to consume a variety of different flavonoid compounds found in different plant-based food and drink. This is easily achievable through the diet: one cup of tea, one apple, one orange, 100 g of blueberries, and 100 g of broccoli would provide a wide range of flavonoid compounds and over 500 mg of total flavonoids," noted lead researchers Nicola Bondonno, PhD, postdoctoral research fellow, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.

"Flavonoids have been shown to be anti-inflammatory and improve blood vessel function, which may explain why they are associated with a lower risk of death from heart disease and cancer," she added.

The ARIC (Atherosclerosis Risk in Communities) study was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services.

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