Heart News and Notes

Supposedly one reason why we overeat is that we are adapted to a scarcity of food, so now when food is plentiful we can’t resist the urge to eat it while it’s there. But Dr. David A. Kessler, who fought our urge to smoke as head of the FDA, has more.

In his new book, The End of Overeating, he says we have a built-in craving for fat, salt and sugar. What’s more, restaurants and packaged food makers have tweaked each recipe to the particular combination of fat, salt and sugar that makes it most attractive. Once we taste it, we can’t resist it.

Kessler has resorted to dumpster-diving to find out what goes into menu items. That’s how he found out that one appetizer, Chili’s Southwestern Eggrolls, gives you 910 calories, 57 grams of fat and 1,960 milligrams of sodium, even as it leaves you, not satisfied, but eager for more.

Will power, he warns, is no defense. But just as we changed our image of smoking, from smart and sophisticated to dirty and dangerous, we can persuade ourselves that these seemingly attractive foods are really repulsive.

Heart failure doesn’t mean the heart stops; it means the heart is still working but not working enough. More people are living with heart failure as they survive heart attacks with damaged hearts. They can live with it for a long time, but so far the only cure is a heart transplant.

Some success has been reported in using stem cells from the patient’s own bone marrow to create new heart muscle. Injected into the heart, some of them appear to become functioning heart muscle cells.

A study at the University of Buffalo suggests a different approach. Injected into a pig’s skeletal muscle, the cells don’t migrate to the heart, but they are reported to generate “trophic factors” that stimulate regrowth of the heart’s own tissue.

Food and the French. Your immediate association is: they love it. Then what happens when Frenchmen have heart failure and have to restrict salt?

As Mme Hélène Guibert, a dietitian with France’s “Réseau Respecti-coeur,” explained recently to Heart Failure Congress 2009 at Nice, France, they still love it. “Meals are important occasions.”

The network’s individualized management program helps the patients work out agreed objectives, draws up shopping lists, and holds interactive cooking demonstrations to develop new cooking skills and new tastes. “The pleasure of eating is retained.”

The largest single factor in the life-prolonging benefit of the Mediterranean diet is alcohol, according to an analysis of the Greek participants in the EPIC trial (European Prospective Investigation into Cance and Nutrition) by Dr. Dimitrios Trichopoulos of the Harvard School of Public Health.

Alcohol accounted for almost one-quarter of the total benefit. The combined effect of eating less meat, and more fruits and vegetables, edged out the effect of alcohol, together accounting for nearly one-third. Fruits and nuts, monounsaturated instead of saturated fats, and legumes accounted for almost another third. Fish, for reasons as yet unknown, didn’t show a significant effect.

But be warned: another study found that excessive consumption of alcohol accounted for four percent of deaths worldwide. As Dr. Trichopoulos said, drink wine unless you like it too much.

A little daily aspirin lowers the risk of heart attack but increases the risk of serious bleeding. If you’ve already had a coronary event like a heart attack or angina, you should take daily aspirin, because you have a high risk of another event.

Now suppose you’ve never had an event, but the doctor says you’re “at risk.” Current guidelines say you should take daily aspirin. But a new meta-analysis (analysis of pooled data from several different trials) at Oxford University (UK) suggests that you’re in greater danger from bleeding due to aspirin than from the heart attacks aspirin might prevent, so you should not take it.

The result is controversial. The authors say they’re not making recommendations, they just analyze data. Other people with the same data have come to different conclusions.

Heart failure is a chronic condition, but acute flare-ups are frequent and must be treated promptly, Professor Ferenc Follath of the University Hospital of Zurich told Heart Failure Congress 2009.

The most common symptom of acute heart failure is shortness of breath, occurring in 92 percent of cases, varying from “suffocation” to “tight chest” to “heavy breathing.” Other signs are cough, swelling in the limbs, chest pain, and difficulty breathing at night or when lying flat, each occurring in roughly one-third of cases. Confusingly, these symptoms can be due to other conditions in elderly patients.

An American study last year found an average delay of 13.3 hours in seeking medical attention for acute heart failure. Experience in Europe showed that prompt treatment reduced mortality by 40 to 50 percent.