Cardiovascular Disease

Cardiovascular disease, commonly manifesting as coronary artery disease and heart attacks, cerebrovascular disease and strokes, peripheral vascular disease etc., is considered as a component of metabolic syndrome. Several studies in recent years have shown a clear relationship between consumption of modern foods and development of cardiovascular diseases. Dietary restrictions, therefore, have a very important role to play in the prevention and management of cardiovascular diseases.

Fructose and cardiovascular disease [See]

Rosset R, Surowska A, Tappy L. Pathogenesis of Cardiovascular and Metabolic Diseases: Are Fructose-Containing Sugars More Involved Than Other Dietary Calories?. Curr Hypertens Rep 2016;18:44. Available at

DiNicolantonio JJ, Lucan SC.The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 2014;1:e000167. doi: 10.1136/openhrt-2014-000167. Available at

Ancient Egyptians Too Had Atherosclerotic Vascular Disease Abstract of Allam AH et al., JAMA, November 18, 2009;302(19); Medpage Today Report; Phys Org Report

Globalization of Food Patterns and Cardiovascular Disease Risk |
Globalization and the epidemiology of obesity

Dietary Patterns and Risk of Mortality From Cardiovascular Disease, Cancer, and All Causes:
See Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women – Circulation, Feb 2009 | A Prospective Cohort of Women; Circulation, 2008;118:230-237 | Dietary Patterns and the Risk of Acute Myocardial Infarction in 52 Countries

Hieronimus B, Medici V, Bremer AA. Synergistic effects of fructose and glucose on lipoprotein risk factors for cardiovascular disease in young adults. Metabolism. November 2020;112:154356. Available at

Malik VS, Hu FB. Fructose and Cardiometabolic Health. Journal of the American College of Cardiology. 2015;66(14):1615-1624. doi: 10.1016/j.jacc.2015.08.025 Available at

Sweetened Beverages Increase Coronary Heart Disease: de Koning L, Malik VS, Kellogg MD, Rimm EB, Willett WC, Hu FB. Sweetened Beverage Consumption, Incident Coronary Heart Disease and Biomarkers of Risk in Men. CIRCULATIONAHA.111.067017 doi: 10.1161/CIRCULATIONAHA.111.067017. [Full Text]

Increasing the ratio of beans to white rice, or limiting the intake of white rice by substituting beans, may lower cardiometabolic risk factors: A new study from Costa Rica, which involved monitoring the diet of almost 2,000 people in an investigation of risk factors for heart disease between 1994 and 2004, has shown that those who regularly traded a helping of white rice for one of beans experienced a 35 per cent reduction in the risk of symptoms that usually lead to diabetes. [Mattei J, Hu FB, Campos H. A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults. Am J Clin Nutr. 2011 Sep;94(3):869-76. Epub 2011 Aug 3. Abstract | Report]

Increased Sodium Increases Cardiovascular Risk: A new, 15-year follow-up study has shown that people with the highest ratio of sodium to potassium in their diet had a significantly increased risk of death from cardiovascular disease compared with those who had the lowest ratio of sodium to potassium intake [Yang Q et al. Sodium and Potassium Intake and Mortality Among US Adults Prospective Data From the Third National Health and Nutrition Examination Survey Arch Intern Med. 2011;171(13):1183-1191. doi:10.1001/archinternmed.2011.257 Abstract | Commentary | Report]

Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease: Modest reductions in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target. Reducing dietary salt by 3 g per day is projected to reduce the annual number of new cases of CHD by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 and to reduce the annual number of deaths from any cause by 44,000 to 92,000 and would save 194,000 to 392,000 quality-adjusted life-years and $10 billion to $24 billion in health care costs annually. Kirsten Bibbins-Domingo et al., Published in N Engl J Med on Jan 20, 2010 [Full Text]

Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies: High salt intake is associated with significantly increased risk of stroke and total cardiovascular disease Full Text of Pasquale Strazzullo et al., BMJ 2009;339:b4567; Report in

High calcium intake as supplements may increase cardiovascular mortality [Mark J Bolland et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 29 July 2010;341:c3691. doi:10.1136/bmj.c3691 Full text | Mark J Bolland et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ. 15 January 2008. doi: 10.1136/bmj.39440.525752.BE Full Text]

Calcium Supplements Increase Vascular Events? See

Chronic exposures to Bisphenol A, widely used in epoxy resins lining food and beverage containers, may lead to diabetes and cardiovascular events.
See Full Text Article in JAMA | Report

No association between egg consumption and the incidence of cardiovascular disease: A study that examined the association between egg consumption and incidence of CVD in a prospective dynamic Mediterranean cohort of 14 185 university graduates found no association between egg consumption and the incidence of CVD [Zazpe I et al. Egg consumption and risk of cardiovascular disease in the SUN Project. European Journal of Clinical Nutrition 2011;65:676–682; doi:10.1038/ejcn.2011.30]

Baked fish reduces and fried fish increases the risk of heart failure in post menopausal women: A 10-year follow-up of more than 84 000 postmenopausal women, who participated in the Women’s Health Initiative–Observational Study (WHI-OS), has found that eating baked or broiled dark fish such as salmon five times a week may prevent heart failure in older women, whereas having fried fish only once a week may increase this risk. [Belin RJ, Greenland P, Martin L, et al. Fish intake and the risk of incident heart failure: The Women’s Health Initiative. Circ Heart Fail 2011; DOI:10.1161/CIRCHEARTFAILURE.110.960450. | Report]

Diet Soda and Salt Increase the Risk of Stroke: In a new study from the University of Miami’s Miller School of Medicine (Northern Manhattan Study), those who drink diet soda were found to have more than a 60% increase in stroke than those who abstain and those who used more than 4g of sodiun per day had double the risk than those who had less than 1.5g per day. Report | Report | Report]

Migraine sufferers twice as likely to have a heart attack: Both driven by sugars?
Report in Science Daily | Report in Telegraph

Childhood Obesity Alone May Increase Risk of Later Cardiovascular Disease: Being obese by as early as 7 years of age may raise a child’s risk of future heart disease and stroke, even in the absence of other cardiovascular risk factors such as high blood pressure, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). Abstract | Report in Science Daily | Report in Modern Medicine

Improved outcomes associated with metformin therapy in patients with diabetes and heart failure: A two year follow-up study has found that metformin use in ambulatory patients with diabetes and heart failure improves outcome, contrary to what was believed. [David Aguilar et al. Metformin Use and Mortality in Ambulatory Patients with Diabetes and Heart Failure CIRCHEARTFAILURE.110.952556 October 15, 2010. doi: 10.1161/​CIRCHEARTFAILURE.110.952556 Abstract | Report]

Almonds may help reduce risk of type 2 diabetes and heart disease: Studyshows that consuming an almond-enriched diet may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with prediabetes. [Michelle Wien et al. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes. Journal of the American College of Nutrition. 2010;29(3):189-197. Abstract | Report]

Increased Potassium Consumption Cuts Cardiovascular Risk by 20%: The largest meta-analysis examining the impact of potassium intake on cardiovascular outcomes has found that higher dietary consumption of potassium is associated with lower rates of stroke and could also reduce the risk of coronary heart disease and total cardiovasular disease. [Abstract from D’Elia L, Barba G, Cappuccio FP, et al. Potassium intake, stroke and cardiovascular disease. A meta-analysis of prospective studies. J Am Coll Cardiol 2011;57:1210-1219. | Report]

Salt Restriction Reduces Cardiovascular Disease Risk
See Report | One More Report | One More..

Fish oil shows beneficial effects in metabolic syndrome: A review published in The Journal of Nutritional Biochemistry, reports that omega-3 fatty acids may promote metabolic changes in visceral (adipose) tissue, leading to significant improvement in metabolic syndrome. [Abstract from Puglisi MJ, Hasty AH, Saraswathi Y. The role of adipose tissue in mediating the beneficial effects of dietary fish oil. Journal of Nutritional Biochemistry.2011;22(2):101-108. doi: 10. 1016/ j.jnutbio.2010.07.003 | Report]

Eating whole grains, compared to refined grain products, could lower heart disease risk A large cross sectional study among the Framingham Heart Study participants has shown that increasing whole-grain intake is associated with lower visceral adipose tissue (VAT) in adults, whereas higher intakes of refined grains are associated with higher VAT.[See Abstract AJCN, Report]


Obesity is now not only more common, but also affecting kids more often. It’s linked to all other problems of metabolic syndrome. In recent years, evidence has been mounting to link the consumption of sugar and sweetened foods with increasing prevalence of obesity, across the ages. Although several therapeutic approaches are being tried, including surgical interventions, the root cause of the obesity epidemic being the modern diet, the most important, most effective, most healthy and least invasive intervention is dietary intervention itself.

Potential mechanisms for fructose-induced insulin resistance. [See]
Main pathways of fructose metabolism that lead to insulin resistance, metabolic syndrome and obesity [See]

Sugar is Toxic: The growing scientific evidence, both epidemiological and mechanistic, very clearly shows that excess sugar induces all of the diseases associated with the metabolic syndrome, Robert H. Lustig et al write in Nature. See Lustig RH, Schmidt LA, Brindis CD. Public health: The toxic truth about sugar. Nature. 02 February 2012;482:27–29. doi:10.1038/482027a[Link][Report | Report | Report | Report]

Isganaitis E, Lustig RH. Fast Food, Central Nervous System Insulin Resistance, and Obesity. Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:2451–2462. Available at

Modern day food causes all the ills: The highly processed, calorie-dense, nutrient-depleted diet frequently leads to exaggerated supraphysiological post-prandial spikes in blood glucose and lipids. This post-prandial dysmetabolism induces immediate oxidant stress, which increases in direct proportion to the increases in glucose and triglycerides after a meal. The transient increase in free radicals acutely triggers atherogenic changes including inflammation, endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity. To attenuate the increase in glucose, triglycerides, and inflammation after a meal,  a diet rich in minimally processed, high-fiber, plant-based foods, including vegetables and fruits, whole grains, legumes, and nuts is recommended. Other dietary interventions that can significantly ameliorate postprandial dysmetabolism include intake of lean protein, vinegar, fish oil, tea, and cinnamon. Additional benefits may result from calorie restriction, weight loss and exercise.See O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J Am Coll Cardiol 2008; 51:249-255 Abstract at | Anti-Inflammatory” Diet May Improve Postprandial Glucose, Cardiovascular Health

Dietary fructose linked to metabolic syndrome and diabetes mellitus: In a new study from Vanderbilt University in Nashville, Tennessee, a diet with 30 percent of total energy from fructose was given to 29 adult male rhesus monkeys aged 12 to 20 years for a period of 12 months. Starting at six months and by the end of the 12-month feeding study, ALL (100%) the monkeys developed certain metabolic syndrome components including body adiposity, insulin resistance, and dyslipidemia and four monkeys (15%) developed type 2 diabetes mellitus. [Bremer AA et al. Fructose-Fed Rhesus Monkeys: A Nonhuman Primate Model of Insulin Resistance, Metabolic Syndrome, and Type 2 Diabetes. Clinical and Translational Science. August 2011;4(4):243–252. Full Text | Report]

Increased fructose consumption from fruits increases metabolic syndrome risk: A cross-sectional population based study on 2537 subjects (45% men) aged 19-70 y has shown that higher consumption of dietary fructose may have adverse metabolic effects and increase the risks for metabolic syndrome. [Firoozeh Hosseini-Esfahani et al. Dietary fructose and risk of metabolic syndrome in adults: Tehran Lipid and Glucose study. Nutrition & Metabolism 2011, 8:50 doi:10.1186/1743-7075-8-50 Full text]

Mortera RR, Bains Y, Gugliucci A. Fructose at the crossroads of the metabolic syndrome and obesity epidemics. Frontiers In Bioscience, Landmark. Jan 1, 2019;24:186-211. Available at

Malik VS, Hu FB. Fructose and Cardiometabolic Health. Journal of the American College of Cardiology. 2015;66(14):1615-1624. doi: 10.1016/j.jacc.2015.08.025 Available at

Zhang D-M, Jiao R-Q, Kong LD. High Dietary Fructose: Direct or Indirect Dangerous Factors Disturbing Tissue and Organ Functions. Nutrients 2017;9(4):335. Available at

Tappy L, Lê K-A. Metabolic Effects Of Sweetened Beverages: Pathophysiology And Mechanistic Insights. CMR e Journal. December 2010;3(3):13-18. Available at

Tappy L, Lê K-A. Metabolic Effects of Fructose and the Worldwide Increase in Obesity. Physiological Reviews January 2010;90(1):23-46. Available at

Tappy L. Fructose-containing caloric sweeteners as a cause of obesity and metabolic disorders.

Fructose (Fruit Sugar) is a more important cause for metabolic disorders like diabetes, hypertension, fatty liver disease, obesity

Fructose in fruits can increase obesity: A new study reports that when fructose was consumed, absolute lipogenesis was 2-fold greater and that an early stimulation of lipogenesis after fructose, consumed in a mixture of sugars, augments subsequent postprandial lipemia. Acute intake of fructose stimulates lipogenesis and may create a metabolic milieu that enhances subsequent esterification of fatty acids flowing to the liver to elevate TG synthesis postprandially. See Parks EJ, Skokan LE, Timlin MT, Dingfelder CS. Dietary Sugars Stimulate Fatty Acid Synthesis in Adults. J. Nutr. June 2008;138:1039-1046 Abstract

Energy Drinks Pose Serious Health Risks for Young People: According to a review of scientific literature and Internet sources, published in Pediatrics, energy drinks that contain caffeine, taurine, sugars and sweeteners, herbal supplements etc., are regularly consumed by 30% to 50% of children, adolescents, and young adults and and are associated with risks for serious adverse health effects such as liver damage, kidney failure, respiratory disorders, agitation, confusion, seizures, psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis, tachycardia, cardiac dysrhythmias, hypertension, myocardial infarction, heart failure, and death. [See Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health Effects of Energy Drinks on Children, Adolescents, and Young Adults. Pediatrics. 2011;127:511-528. DOI: 10.1542/peds.2009-3592. Free Full Text | Report]

Sugar sweetened beverages increase the risk of weight gain, development of metabolic syndrome and type 2 diabetes, meta analysis shows [See Malik VS et al. Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes A meta-analysis. Diabetes Care November 2010;33(11):2477-2483 Free Full Text]

Sugar Sweetened Beverages Increase the Risk of Metabolic Syndrome, Diabetes and Obesity Vasanti S. Malik et al. Sugar Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A Meta-analysis Diabetes Care. August 2010;33(8) Full Text | Report]

Duwaerts CC, Maher JJ. Macronutrients and the Adipose-Liver Axis in Obesity and Fatty Liver. Cellular and Molecular Gastroenterology and Hepatology2019;7(4):749-761. Available at

Lakhan SE, Kirchgessner A. The emerging role of dietary fructose in obesity and cognitive decline. Nutr J 2013;12:114. Available at

Metabolic disorders striking the young: Should the stress be on ‘Stress’ or on Food? Many reports emerging from India reveal increasing incidence of metabolic syndrome disorders in young children and many things such as stress at school, sedentary life style, computers, TV, genes and junk food have been blamed. Some have even advised the kids to stop schooling and do yoga for relaxation! Is it not ironical that the so called experts who sought changes in our school education, so as to make it less stressful, now blame the changed methodology for increasing stress? In blaming many things, the strongest reason is bound to be missed: and that reason is the FOOD! See The Young Are Ageing. Outlook Sep 13, 2010 Full Text | Delhi kids suffer from adult ailments! Wonder Woman Sep 8, 2010 Full Text]

Apple Or Pear-Shaped Body Type Equally Dangerous: A study of 220,000 people suggests that being obese – having a body mass index (BMI) of 30 or more – is a major risk factor for heart disease, but found the distribution of fat on the body has no impact on that risk. [The Emerging Risk Factors Collaboration Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. The Lancet. 11 March 2011. doi:10.1016/S0140-6736(11)60105-0 Full Text | Report]

Metabolic Syndrome May be Due to Disease Causing Fat Cells: UC Davis Health System researchers have reported a novel observation that subcutaneous fat of MetS has increased macrophage recruitment with cardinal crown-like structure features and contributes to the increased cellular inflammation that produces increased levels of biomarkers that are correlated with both insulin resistance and low-grade inflammation. [Bremer AA et al. Adipose Tissue Dysregulation in Patients with Metabolic Syndrome. The Journal of Clinical Endocrinology & Metabolism August 24, 2011 jc.2011-1577. Abstract | Report]

Diet and Obesity May be Linked to Alzheimer’s: A Swedish study that included 8,534 twins over the age of 65, has found that the risk of dementia was almost double in those who were overweight versus those of normal weight and those who were obese had almost a fourfold increase in risk. [Johansson K at al. Longer term effects of very low energy diet on obstructive sleep apnoea in cohort derived from randomised controlled trial: prospective observational follow-up study BMJ 2011; 342:d3017  Abstract | Report | Older Paper]

Premature Death Awaits Obese Kids
Paul W. Franks et al., New Eng Journal Med., 11 February 2010 | Business Week Report

Childhood Obesity Alone May Increase Risk of Later Cardiovascular Disease Being obese by as early as 7 years of age may raise a child’s risk of future heart disease and stroke, even in the absence of other cardiovascular risk factors such as high blood pressure, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). Abstract | Report in Science Daily | Report in Modern Medicine

Overweight Kids Risk Weak Bones, Diabetes: Abdominal Fat May Play a Role in Bone Strength Norman K Pollock et al. Lower bone mass in prepubertal overweight children with pre-diabetes Journal of Bone and Mineral Research Jul 2010 Abstract | Report]

Higher-Protein/Low-GI Diet Best for Maintaining Weight Loss [See Larsen TM et al. Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance. N Engl J Med November 25, 2010; 363:2102-2113 Abstract | Report]

A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss A new randomized trial comparing a low-carbohydrate diet with a low-fat diet in combination with the weight-loss drug orlistat has found that both strategies produced meaningful weight loss and the low-carb diet in addition produced significant improvements in blood pressure. William S. Yancy Jr, et al., Published in Arch Intern Med. on Jan 25, 2010 [Abstract] | Report]

Low-Carb and Mediterranean Diets Better than Low-Fat for Weight Loss, Lipid Changes at 2 Years: Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets, offering more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet). See Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229-241 Full text Article

Low carbohydrate and high monounsaturated fat diets help weight loss and offer metabolic benefits Brehm BJ,  D’Alessio DA. Weight Loss and Metabolic Benefits With Diets of Varying Fat and Carbohydrate Content: Separating the Wheat From the Chaff Nature Clinical Practice Endocrinology & Metabolism Available at

Rely on internal cues of meal cessation to keep off obesity Wansink B, Payne CR, Chandon P. Internal and External Cues of Meal Cessation: The French Paradox Redux? Obesity 2007;15:2920-2924. Available at

Higher Fat at Breakfast May Be Healthier: University of Alabama research reveals that mice fed a meal higher in fat had normal metabolic profiles and in contrast, mice that ate a more carbohydrate-rich diet in the morning and consumed a high-fat meal at the end of the day saw increased weight gain, adiposity, glucose intolerance and other markers of the metabolic syndrome. [MS Bray, J-Y Tsai et al. Time-of-day-dependent dietary fat consumption influences multiple cardiometabolic syndrome parameters in mice. International Journal of Obesity. 30 March 2010.] doi:10.1038/ijo.2010.63 [Abstract] | UAB Report]