Coffee spikes your Cholesterol: the Cafestol and Kahweol effect

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The bad news of a high cholesterol reading was a bit of a shock for me.

I knew my diet had slipped (too much red meat, too much cheese: I love cheese). Equally,  I knew that to reduce  cholesterol  “all you had to do”  was cut down on red meat and saturated fat.

I’d been doing blood work for some of my clients and was able to  use my home blood test machine to check my level.

I was horrified.

3 weeks after a major diet shift my cholesterol remained  stupidly high. I looked over  the guidelines again, and  focused on the fibre content, so I bought fibre ( oat and wheat) and added that. Rather than my horror 311 readings I was getting 270’s 280’s.

Still,  80 points over my threshold.

I then started daily tests and compared the results with my food diary. I saw days where I had nothing but some fruit and a few cups of coffee with stupid cholesterol levels.

Equally, I noticed a no coffee day, producing a low reading.

I started researching coffee.  A lot.

What I rediscovered was this.

By the turn of the  20th century, medical, and food researchers knew one thing for sure.

Unfiltered coffee is a cholesterol bomb. There were so many studies all saying the same thing, and much of the research can be seen in this report

“Cafestol and Kahweol.  Review of Toxicological Literature 1999”.

Source here

Drink unfiltered coffee and it sends your Cholesterol rocketing due to two chemicals in coffee called Cafestol and Kahweol.

The numerous tests and reports quoted in the review of Toxicological Literature nailed this fact to the mast  (see appendix 1)

So why doesn’t every coffee shop in the UK have a massive warning plastered all over it? Everybody hears how bad red meat and saturated fat  is for cholesaterol, so when you see your doctor after a high cholesterol test, why don’t they ask about your coffee consumption?

Well, everybody loves coffee. So there is an understandable bias in its favour.

Crucially in the 1990’s when this was discovered, most people drank filtered coffee “the cholesterol-raising effect seems to be limited to coffee that hasn’t been filtered, which includes Turkish coffee, coffee brewed in a French press, and the boiled coffee consumed in Scandinavia”   . (Harvard health in 2012 ) in fact “The cholesterol-raising ingredients in coffee are oily substances called diterpenes, and the two main types in coffee are cafestol (pronounced CAF-es-tol) and kahweol (pronounced KAH-we-awl).

But a paper filter traps most of the cafestol and kahweol, so coffee that’s been filtered probably has little, if any, effect on cholesterol levels.”

This was fine back in the last 20th century.  We mainly drank filtered coffee then . Im 58, I know.

But Guess what? Since the start of the 21st century unfiltered coffee consumption has rocketed. While some coffee shops have an unfiltered coffee option, most push and market unfiltered coffee

I don’t know how many coffee shops there were in 1999, but since 2008 the amount of coffee shops in the UK have grown from 10,000 to 25,000 in 2019. Most  coffee shops offer unfiltered coffee.

Thats a lot of cholesterol raising!

So, I should make it clear, I love coffee. The only effect  this  rediscovery has had  on me is to switch to filtered coffee. I’ve even cut filter paper into  small  circles to put into espresso machines. Some coffee shop don’t mind doing this.

The real horror is this.

If I had gone back to my doctor, they would have pushed me to go on statins. They would not have even mentioned coffee. Im guessing that anyone who has 2 cups of unfiltered coffee a day, and is on statins, should drink filtered coffee and get retested ( having chatted to their doctor first , ofcourse)

In balance I should say that coffee and caffeine have health effects. I think, almost all of which can be obtained through the filtered variety.

 

 

Appendix 1

In an open randomized study, healthy male and female volunteers who drank coffee containing 148 mg cafestol and kahweol daily for 30 days exhibited a considerable rise in total cholesterol (average mean, 31.6%), low density lipoprotein (LDL) cholesterol (50.2%), and triglyceride concentrations (87%) versus the control group (Heckers et al., 1994).

In three volunteers, consumption of highly purified cafestol (73 mg/day; 0.23 mmol/day) and kahweol (58 mg/day; 0.19 mmol/day) as the corresponding mono- and dipalmitates for 6 weeks increased the serum levels of cholesterol by 66 mg/dL (1.7 mmol/L) and triglycerides by 162 mg/dL (1.83 mmol/L) (Weusten-Van der Wouw et al., 1994).

In a randomized, crossover trial using healthy, normolipemic volunteers, six subjects received 2 g Arabica oil containing 72 mg (0.23 mmol) cafestol per day and 53 mg (0.17 mmol) kahweol per day, and five subjects received 2 g Robusta oil providing 40 mg (0.13 mmol) cafestol per day and 2 mg (0.006 mmol) kahweol per day (Mensink et al., 1995). Compared to a control group given placebo oil, serum triglyceride levels increased 71% in the group receiving Arabica oil and 61% in the group given Robusta oil. Serum cholesterol concentrations were increased by 13% for both oils.

references

Cafestol and Kahweol.  Review of Toxicological Literature 1999  accessed online  (Sept/Oct 2019) https://ntp.niehs.nih.gov/ntp/htdocs/chem_background/exsumpdf/cafestol_508.pdf

Heckers, H., U. Göbel, and U. Kleppel. 1994. End of the coffee mystery: Diterpene alcohols raise serum low-density lipoprotein cholesterol and triglyceride levels. J. Intern. Med. 235(2):192-193.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mensink, R.P., W.J. Lebbink, I.E. Lobbezoo, M.P. Weusten-Van der Wouw, P.L. Zock, and M.B. Katan. 1995. Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man. J. Intern. Med. 237(6):543-550.

In a randomized, double-blind parallel study, van Rooij et al. (1995) found that Arabica oil, containing 68 mg (0.21 mmol)/kg cafestol and 85 mg (0.27 mmol)/kg kahweol, raised serum total cholesterol by 44.1 mg/dL (1.14 mmol/L) and plasma triglycerides by 72 mg/dL (0.81 mmol/L) but that the effects of Robusta oil, providing 29 mg (0.092 mmol)/kg cafestol and 1 mg (0.003 mmol)/kg kahweol, were not statistically significant. At a daily dose of 3 g coffee oil for 4 weeks, subjects showed increases of 49 mg/dL (1.3 mmol/L) in serum cholesterol, 73 mg/dL (0.82 mmol/L) in serum triglycerides, and 41 U/L in serum alanine aminotranferase (ALT) activity (upper limit of normal = 53.5 U/L) (Weusten-Van der Wouw et al., 1994). When a coffee oil fraction enriched in non-triglyceride lipids (0.75 g/day, providing a daily dose of 81 mg [0.26 mmol] cafestol and 98 mg kahweol [0.31 mmol]) was given, similar increases resulted. In contrast, 2 g/day of coffee oil stripped of cafestol and kahweol had no effect. 14 ILS Integrated Laboratory Systems TOXICOLOGICAL SUMMARY FOR CAFESTOL AND KAHWEOL 10/99 Consumption of coffee including fine particles suspended in the coffee (fines) containing cafestol and kahweol was shown to be associated with an increase in serum cholesterol and ALT activity in volunteers in a randomized controlled parallel study (Urgert et al., 1995a). In the test group—members of which ingested 8 g fines with a mean of 39 mg (0.12 mmol) cafestol and 49 mg (0.16 mmol) kahweol daily for 21 days—the serum cholesterol level increased by 25 mg/dL (0.65 mmol/L), the triglyceride concentration by 27 mg/dL (0.30 mmol/L), and ALT activity increased by 18 U/L (upper limit of normal = 53.5 U/L), compared to control values. Levels returned to baseline 14 weeks after the trial. In a separate study on particle size, coarse coffee grounds, providing a daily intake of 37 mg (0.12 mmol) cafestol and 54 mg (0.17 mmol) kahweol, and fine coffee grounds, providing 48 mg (0.15 mmol) cafestol and 56 mg (0.18 mmol) kahweol per day, both resulted in a mean serum cholesterol concentration of 189 mg/dL (4.9 mmol/L). Mean triglyceride levels and ALT activity in serum, however, were higher with the consumption of the latter. In a study using unfiltered brewed coffee (cafetière) versus filtered coffee, Urgert et al. (1996b) found elevated levels of total cholesterol (specifically, LDL cholesterol), ALT activity, and triglycerides in individuals who had consumed 0.9 L cafetière coffee (38 mg [0.12 mmol] cafestol, 33 mg [0.10 mmol] kahweol) per day for 24 weeks; the filtered coffee provided <1 mg of the diterpenes. ALT activity was increased 80% above baseline values relative to filtered coffee. All increases, however, were reversible upon withdrawal of treatment. The elevation of ALT suggests the liver is the target organ of cafestol and kahweol (Weuston-Van der Wouw et al., 1994; Urgert et al., 1996c). However, a study of the chronic intake of coffee (consumption of 5 or more cups of boiled or filtered coffee per day and persons aged 40-42 years) found no increased ALT activity (Urgert et al., 1996c). The effects of kahweol on serum lipids and liver aminotransferases were studied by Urgert et al. (1997) through comparison of the effects of pure cafestol (60 mg; 0.19 mmol) with a mixture of cafestol and kahweol (60 mg plus 48-54 mg [0.15-0.17 mmol] kahweol) in a crossover trial. In ten male volunteers, consumption of pure cafestol increased total cholesterol by 17%, LDL cholesterol by 19%, and triglycerides by 86%. The mixture of cafestol and kahweol caused further increases of 2%, 4%, and 7%, respectively. Similar responses were obtained from both treatments on ALT activity.

Source here Cafestol and Kahweol Review of Toxicological Literature 1999

references

Heckers, H., U. Göbel, and U. Kleppel. 1994. End of the coffee mystery: Diterpene alcohols raise serum low-density lipoprotein cholesterol and triglyceride levels. J. Intern. Med. 235(2):192-193.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

Mensink, R.P., W.J. Lebbink, I.E. Lobbezoo, M.P. Weusten-Van der Wouw, P.L. Zock, and M.B. Katan. 1995. Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man. J. Intern. Med. 237(6):543-550.

Urgert, R., S. Meyboom, M. Kuilman, H. Rexwinkel, M.N. Vissers, M. Klerk, and M.B. Katan. 1996b. Comparison of effect of cafetière and filtered coffee on serum concentrations of liver aminotransferases and lipids: Six month randomized controlled trial. Br. Med. J. 313:1362- 1366.

Urgert, R., M.P.M.E. Weusten-Van der Wouw, R. Hovenier, P.G. Lund-Larsen, and M.B. Katan. 1996c. Chronic consumers of boiled coffee have elevated levels of lipoprotein(a). J. Intern. Med. 240:367-371.

Urgert, R., N. Essed, G. van der Weg, T.G. Kosmeijer-Schuil, and M.B. Katan. 1997. Separate effects of the coffee diterpenes cafestol and kahweol on serum lipids and liver aminotransferases. Am. J. Clin. Nutr. 65(2):519-524.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

NPR from 2012 discusses fasting before a cholesterol test “Black coffee, thank goodness, is usually allowed”.

“Unfiltered coffee has much less effect on your heart disease risk than smoking, high blood pressure or being overweight,” says Dr. Martijn B. Katan, a professor at the Wageningen Center for Food Sciences and Wageningen University.

Unless you’re drinking significant amounts of unfiltered or French press coffee on a daily basis, raised cholesterol levels shouldn’t be much of a concern — at least, not when it comes to coffee. On the contrary, coffee may be able to deliver numerous health benefits. here

comforting phrases  nudge people off the scent  “Studies by a co-author – Dr. Martijn B. Katan of Vriye Univeriteit Amsterdam, Institute for Health Sciences, The Netherlands – indicate that consuming five cups of French press coffee per day (30 milligrams of cafestol) for four weeks raises cholesterol in the blood 6 to 8 percent”

“Coffee drinkers concerned about cholesterol weren’t happy about some early study results showing that coffee seems to increase cholesterol levels, and “bad” LDL cholesterol levels in particular. But upon closer inspection, the bad news turned out to be not so bad, because the cholesterol-raising effect seems to be limited to coffee that hasn’t been filtered, which includes Turkish coffee, coffee brewed in a French press, and the boiled coffee consumed in Scandinavia”  and “Espresso contains more cafestol and kahweol than paper-filtered coffee, but because it is consumed in smaller amounts, it may not have much of an effect on people’s LDL level”    . (Harvard health in 2012 )

Basic life support: First aid

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As its “restart a heart” week, I thought it would be good to put the official CPR  guidance on this site.  First aid protocols are set by reference to the standards of the resuscitation council and to the current edition of the first aid guides produced by The St John Ambulance and the Red Cross.

You can look up the  Resuscitation Council here

SEQUENCE Technical description
SAFETY Make sure you, the victim and any bystanders are safe

 
RESPONSE Check the victim for a response

  • Gently shake his shoulders and ask loudly: “Are you all right?”

If he responds leave him in the position in which you find him, provided there is no further danger; try to find out what is wrong with him and get help if needed; reassess him regularly
AIRWAY Open the airway

  • Turn the victim onto his back
  • Place your hand on his forehead and gently tilt his head back; with your fingertips under the point of the victim’s chin, lift the chin to open the airway
BREATHING Look, listen and feel for normal breathing for no more than 10 seconds
In the first few minutes after cardiac arrest, a victim may be barely breathing, or taking infrequent, slow and noisy gasps. Do not confuse this with normal breathing. If you have any doubt whether breathing is normal, act as if it is they are not breathing normally and prepare to start CPR
DIAL 999 Call an ambulance (999)

  • Ask a helper to call if possible otherwise call them yourself
  • Stay with the victim when making the call if possible
  • Activate the speaker function on the phone to aid communication with the ambulance service
SEND FOR AED Send someone to get an AED if available
If you are on your own, do not leave the victim, start CPR
CIRCULATION Start chest compressions

  • Kneel by the side of the victim
  • Place the heel of one hand in the centre of the victim’s chest; (which is the lower half of the victim’s breastbone (sternum))
  • Place the heel of your other hand on top of the first hand
  • Interlock the fingers of your hands and ensure that pressure is not applied over the victim’s ribs
  • Keep your arms straight
  • Do not apply any pressure over the upper abdomen or the bottom end of the bony sternum (breastbone)
  • Position your shoulders vertically above the victim’s chest and press down on the sternum to a depth of 5–6 cm
  • After each compression, release all the pressure on the chest without losing contact between your hands and the sternum;
  • Repeat at a rate of 100–120 min-1
GIVE RESCUE BREATHS After 30 compressions open the airway again using head tilt and chin lift and give 2 rescue breaths

  • Pinch the soft part of the nose closed, using the index finger and thumb of your hand on the forehead
  • Allow the mouth to open, but maintain chin lift
  • Take a normal breath and place your lips around his mouth, making sure that you have a good seal
  • Blow steadily into the mouth while watching for the chest to rise, taking about 1 second as in normal breathing; this is an effective rescue breath
  • Maintaining head tilt and chin lift, take your mouth away from the victim and watch for the chest to fall as air comes out
  • Take another normal breath and blow into the victim’s mouth once more to achieve a total of two effective rescue breaths. Do not interrupt compressions by more than 10 seconds to deliver two breaths. Then return your hands without delay to the correct position on the sternum and give a further 30 chest compressions

Continue with chest compressions and rescue breaths in a ratio of 30:2

If you are untrained or unable to do rescue breaths, give chest compression only CPR (i.e. continuous compressions at a rate of at least 100–120 min-1)
IF AN AED ARRIVES Switch on the AED

  • Attach the electrode pads on the victim’s bare chest
  • If more than one rescuer is present, CPR should be continued while electrode pads are being attached to the chest
  • Follow the spoken/visual directions
  • Ensure that nobody is touching the victim while the AED is analysing the rhythm

If a shock is indicated, deliver shock

  • Ensure that nobody is touching the victim
  • Push shock button as directed (fully automatic AEDs will deliver the shock automatically)
  • Immediately restart CPR at a ratio of 30:2
  • Continue as directed by the voice/visual prompts

If no shock is indicated, continue CPR

  • Immediately resume CPR
  • Continue as directed by the voice/visual prompts
CONTINUE CPR Do not interrupt resuscitation until:

  • A health professional tells you to stop
  • You become exhausted
  • The victim is definitely waking up, moving, opening eyes and breathing normally

It is rare for CPR alone to restart the heart. Unless you are certain the person has recovered continue CPR
RECOVERY POSITION If you are certain the victim is breathing normally but is still unresponsive, place in the recovery position

  • Remove the victim’s glasses, if worn
  • Kneel beside the victim and make sure that both his legs are straight
  • Place the arm nearest to you out at right angles to his body, elbow bent with the hand palm-up
  • Bring the far arm across the chest, and hold the back of the hand against the victim’s cheek nearest to you
  • With your other hand, grasp the far leg just above the knee and pull it up, keeping the foot on the ground
  • Keeping his hand pressed against his cheek, pull on the far leg to roll the victim towards you on to his side
  • Adjust the upper leg so that both the hip and knee are bent at right angles
  • Tilt the head back to make sure that the airway remains open
  • If necessary, adjust the hand under the cheek to keep the head tilted and facing downwards to allow liquid material to drain from the mouth
  • Check breathing regularly

Be prepared to restart CPR immediately if the victim deteriorates or stops breathing normally
Basic life support
ChainOfSurvival

Measuring cups

andrewstemler 1 Comment

Over the years, Ive spoken to a lot of people about food and quantities of food. Whenever I’ve checked that the would be dieter has a set of cups, everyone , everyone goes “yes”.

Just to confirm, I say ” do you have a set of cups?” they say, “Yes”.

In 9/10 times these people are lying, or are very ignorant, or very stupid.

A set of cups is a specific way of measuring quantities.  Here is a pictureandrew stemler cups

You can buy them online. Here are some cheap plastic ones and here are some more expensive stainless steel ones.

As much as I hate the smart arse phrase ” if you’re not measuring you’re guessing“: in food, its spot on.

At costs ranging from £1.35 to £12 you really do need to get some way of measuring food!

Hippy protein: the Game Changers effect.

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The recently release film (documentary) the Game Changers has brought “meat free” protein sources back to the top of the nutritional agenda. It seems you no longer need to be a tree hugging hippy to see if you can get your protein from none meat sources.

For years there has been a grumble of bad PR about red meat and processed meat, although some dispute that meat has any down side.

That said, its  now worth while noting the growth of  this concern about the constant consumption of meat both from a health and environmental cost perspective . So it’s as well to experiment with plant protein and at the  very least, least mix it up a bit.

The fact that  James Cameron, Arnold Schwarzenegger and Jackie Chan all got together to support a film that promotes ” more veggie” is in itself worth noting.

So here is an outline of some useful veggie sources of protein. (BTW a CUP is a specific measure)

Green Peas. One cup is about 8 grams of protein. I love peas.

Quinoa. 8 gm a cup! Includes all nine essential amino acids . Ive never tried it. I must!

Beans.  Two cups of kidney beans, for example, contain about 26 grams. But buying them and soaking them is a bit of bind, so buy them in can form!

Tempeh and Tofu. Ive never liked these. I always though soya was a genetically modified alien that stuck to your face, laid eggs in your tummy that exploded through your abdomen. I could be wrong. Allegedly contains about 15 and 20 grams  of protein per half cup. But, I must try again.

Edamame: Soya as god intended. Boiled edamame contains 8.4 grams of protein per half cup. Must try it. Having written that, Im already anxious.

Leafy greens cabbage and stuff. I love these, but Ive never really thought of them as a protein source. Allegedly two cups of raw spinach contain 2.1 grams of protein, and one cup of chopped broccoli contains 8.1 grams.

Hemp seeds. If you can resist planting them out under high pressure sodium lights to make drugs,10 grams of protein in 3 tablespoons.

Chia seeds. 4.7 grams in 2  tablespoons. But really ” TWO TABLESPOONS”. Thats a lot to hide

Sesame, sunflower and poppy seeds. Throw these in your earth saving muesli volume, sunflower seed 7.3 grams of protein per quarter cups. Sesame seeds and poppy seeds ( per 1/4 cup) at 5.4 grams each.

Seitan. Never tried it, seen it, or heard about it until now ( 2019 really is my year)!!. But basically, it’s a wheat gluten. So whilst middle class folk are swooning from gluten intolerance,  the hippies are chowing down on it. 75gms of protein in 100 gms.

Chick peas 7.3 grams of protein in just half a cup, and are also high in fiber and low in calories.

Practice the basics

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You can analyse and use the olympics lifts in many many ways. One is  to view the full skill is a pressure test for your front and overhead squat. The pure ” beautiful” form of the lifts are seen as the squat clean and  squat snatch.

Put in other words, it tests if you own a superb front and back squat to the extend that you  can jump into it with a great big weight. Any squat wobble or misunderstanding of your squat form means that, under pressure, you won’t be get under the bar.

Take home message: don’t skimp on your front squat and overhead squat practice!

Short term skipping of meals produces an immediate increase in cholesterol levels.

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Just a personal reflection.

I was reviewing my food diary/cholesterol log. On those days when I had a tiny  breakfast, and  in effect, fasted throughout the day ( with some cups of tea and a bit of fruit), on those days, I noticed the cholesterol went back up!

superficially the report

Intermountain Medical Center. “Fasting reduces cholesterol levels in prediabetic people over extended period of time, new research finds.” ScienceDaily. ScienceDaily, 14 June 2014.

States that fasting reduces cholesterol over the longer term however  “During actual fasting days, cholesterol went up slightly in this study, as it did in our prior study of healthy people, but we did notice that over a six-week period cholesterol levels decreased by about 12 percent in addition to the weight loss,” said Dr. Horne

“Because we expect that the cholesterol was used for energy during the fasting episodes and likely came from fat cells, this leads us to believe fasting may be an effective diabetes intervention.”

The process of extracting LDL cholesterol from the fat cells for energy should help negate insulin resistance. In insulin resistance, the pancreas produces more and more insulin until it can no longer produce sufficient insulin for the body’s demands, then blood sugar rises.

“The fat cells themselves are a major contributor to insulin resistance, which can lead to diabetes,” he said. “Because fasting may help to eliminate and break down fat cells, insulin resistance may be frustrated by fasting.”

Dr. Horne says that more in-depth study is needed, but the findings lay the groundwork for that future study.

“Although fasting may protect against diabetes,” said Dr. Horne. “It’s important to keep in mind that these results were not instantaneous in the studies that we performed. It takes time. How long and how often people should fast for health benefits are additional questions we’re just beginning to examine.”

This clearly leads into a re-evaluation of intermittent fasting

The European Society of Endocrinology asked  “Could intermittent fasting diets increase diabetes risk? Fasting every other day to lose weight impairs the action of sugar-regulating hormone, insulin, which may increase diabetes risk.” ScienceDaily. 20 May 2018.

Their conclusion  was “Fasting every other day to lose weight impairs the action of sugar-regulating hormone, insulin, which may increase diabetes risk, according to data presented in Barcelona at the European Society of Endocrinology annual meeting, ECE 2018. These findings suggest that fasting-based diets may be associated with long-term health risks and careful consideration should be made before starting such weight loss programmes”

Anecdotally this makes me think about lots of thin/skinny people I know, who have poor health!

A healthy gut microbiome, watching your waist size and getting enough sleep

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Eating a diet that encourages a healthy gut microbiome, avoiding central obesity (fat in the stomach region) and getting enough sleep are among the many dietary and lifestyle factors that may help to protect against heart disease and stroke, according to findings of a new Task Force report from the British Nutrition Foundation (BNF), entitled Cardiovascular Disease: Diet, Nutrition and Emerging Risk Factors: 2nd Edition. The evidence for other emerging risk factors that may increase risk – such as being sedentary for long periods, and poor diet in pregnancy – were presented at a conference for academics and health professionals to launch the Task Force report in London today.

In the UK, the death rate from cardiovascular disease (CVD), which includes heart disease and stroke has been falling but it is still one of the leading causes of death. There are a number of treatments available, which have contributed to reducing mortality, but ill health associated with CVD (morbidity) remains high and could even be rising in older age groups.

Professor Keith Frayn Emeritus, Professor of Human Metabolism, University of Oxford and Chair of the Task Force, said: “Conventional lifestyle-related risk factors for cardiovascular disease include smoking, raised cholesterol and blood pressure, lack of physical activity, obesity and diabetes. However, these ‘classical’ risk factors cannot fully explain differences in cardiovascular disease risk and emerging evidence suggests that other novel risk factors may play an important role.”

The Task Force report explores some of the emerging and novel risk factors and how they can affect our risk of heart disease and stroke.

Gut health

Scientific research shows that eating plenty of wholegrains and other fibre rich foods is important for a healthy gut, but the Task Force report highlights that the fermentation of fibre by our gut bacteria may also influence our risk of heart disease.

Sara Stanner, Science Director at the BNF and editor of the Task Force report said: “As a nation we’re consuming well below the recommended intake for fibre. Eating plenty of fruit and vegetables, choosing high-fibre or wholegrain varieties of starchy carbohydrates, and eating plenty of pulses, like beans, peas and lentils, will contribute to fibre intakes and can help to keep your gut healthy and decrease your risk of heart disease.”

Central fat

It’s known that being overweight increases your risk of heart disease and stroke, but where you carry any excess fat is also important in determining the risk of heart disease and stroke. The new Task Force report explains that people who have excess fat around the stomach are at increased risk because the cells secrete a number of substances that can contribute to risk.

Stanner said: “Regardless of height or BMI, people should try to lose weight if their waist measures more than 94cm (37ins) for men and 80cm (31.5ins) for women.”

Minerals

There is a well-established link between sodium in salt and risk of high blood pressure but other minerals like calcium, magnesium and potassium may play a role in preventing high blood pressure and have positive effects on other risk factors for heart disease and stroke.

Stanner said: “Eating a varied diet will help to ensure you get all the essential minerals you need; potassium is found in foods like bananas, potatoes and fish, magnesium in lentils and wholegrains and calcium in dairy foods and some green leafy vegetables.”

Sleep

Evidence in the Task Force report suggests that it is not just a lack of sleep but also poor quality and interrupted sleep that may be linked to an increased risk of heart disease, stroke, type 2 diabetes, obesity, and hypertension.

Stanner said: “There is emerging evidence that inadequate sleep is linked to increased risk of cardiovascular disease. For general health, adults should aim for between seven and nine hours sleep a night.”

Workplace stress

Many scientific studies have linked stress with ill-health but the link between job-related stress and increased risk of heart disease and stroke is becoming more widely recognised. The report suggests that exposure to stress activates specific regions of the brain, leading to an increase in heart rate and blood pressure, which can affect blood vessel walls and damage the functioning of the blood vessel lining.

Stanner said: “If you’re exposed to stress in the workplace it’s a good idea to find relaxation techniques that suit you, and actively work at managing your stress levels.”

Other risk factors

Other significant risk factors identified by the Task Force report include birthweight (both high and low birthweights are associated with increased risk of heart disease in later life), excessive consumption of alcohol and sedentary behaviour, even if interspersed with physical activity.
Here is  BNF’s “Helping to protect yourself from heart disease and stroke chart “Helping to protect yourself from heart disease and stroke