Coronary heart disease (CHD) is a major cause of death and ill health. One of the risk factors for CHD is elevated blood levels of total cholesterol and of low density lipoprotein cholesterol. Existing observational studies indicate that wholegrain cereals may reduce the risk of CHD, possibly by reducing cholesterol levels.
A Cochrane Systematic Review identified ten trials that assessed the effect of giving wholegrain foods to adults. Of these studies, eight used wholegrain oats. The trials involved a total of 914 adults who had at least one major risk factor for CHD. All were short-term studies lasting only 4 to 8 weeks and involved small numbers of people; most were wholly or partly funded by companies that had interest in cereal products.
Well-designed, adequately powered studies are now needed to evaluate the effects of long-term consumption of oats, says Dr Sarah Kelly of the School of Health and Social Care at the University of Teesside, Middlesbrough.
The review concluded that there is enough evidence from wholegrain oats to suggest that healthcare professionals could recommend oats as part of cholesterol reduction programmes.
The Researchers also point to an inconsistency in the use of the term wholegrain ™. Some reviews of wholegrain products include studies conducted with dietary fibre or oat bran and have referred to these refined products as wholegrain. There is a need for greater clarity and consistency between the terms wholegrain, bran, germ and fibre in published research.
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Detailed information about cardiovascular and other health problems was sought from participants in the earlier trials. As part of this researchers found that participants who had cut back on salt during the trials tended to stick to a lower salt diet compared to those who had been in the control group. In total the researchers obtained information from 2415 (77.3%) participants, 200 of whom had reported some sort of cardiovascular problem.
The reduction in the risk of developing cardiovascular problems as a result of the sodium reduction intervention was substantial. The results showed these pre-hypertensive individuals were 25% less likely to develop cardiovascular problems over the course of the 10-15 years post-trial. There was also a 20% lower mortality rate. This risk reduction was evident in each trial.
To the authors knowledge this study is the first and only study of sufficient size and duration to assess the effects of a low salt diet on cardiovascular problems based on randomised trial data. It provides unique evidence that lowering salt in the diet might prevent cardiovascular disease.
bmj