Health In Focus
  • Single Nucleotide Polymorphisms (SNPs) in the chromosome 9p21 increase the risk for cardiovascular disease
  • Study conducted to analyze if the 'Prudent Diet' lowers the risk for cardiovascular disease (CVD).
  • Results show lowered risk for CVD with reduction in body composition.
Genetic influence on coronary heart disease has been a source of intense study over the past few years. The most significant single nucleotide polymorphism (SNP) that has been associated with myocardial infarction, revascularization or angina has been the mutation at chromosome 9p21.

Researchers identified the association between this polymorphism and cardiovascular disease when they analyzed study subjects who were affected by cardiovascular disease with no known prior risk factor. The mutations that existed in the study subjects were not present in the controls.
‘Prudent’ Diet Could Lower Risk of Cardiovascular Disease
'Prudent Diet' Could Lower Risk of Cardiovascular Disease

Association Between SNP at 9p21 and Cardiovascular Disease

Riyaz S. Patel and colleagues from The University College London carried out a meta-analysis of the research data available on the SNP at 9p21 and cardiovascular risk. The analysis showed that there was a consistent association between cardiovascular risk and SNP at 9p21.

Influence of Dietary Factors on Cardiovascular Disease Risk in People with SNP at 9p21

George Hindy and colleagues from Lund University, Sweden studied the effect of dietary factors like intake of high volume of vegetables and consumption of wine on increased cardiovascular risk among people with 9p21 single nucleotide polymorphism rs4977574. The study showed that people who carried the mutation rs4977574 showed an increased risk for cardiovascular disease among people who consumed moderate to high level of vegetables and little or no consumption of wine. Further, among individuals who carried the risk allele, there was an elevated level of HbA1C for those who consumed low level of vegetables.

Diet and Genetic Intervention Pilot Study

Michael A. Zulyniak and colleagues from McMaster University studied the effect of two different types of diet on the risk of cardiovascular disease among people with 9p21 SNP. This study titled "A randomized controlled trial of the effects of a prudent diet on cardiovascular risk factors, gene expression, and DNA methylation - the Diet and Genetic Intervention (DIGEST) Pilot study" was published in BMC Nutrition.

The study participants were recruited into the study through newspaper advertisements and were young and healthy men and women. The promise of free provision for the duration of the study was a major attraction for the participants along with the provision of the genetic risk for cardiovascular disease.

The study participants were allowed to make their own meals based on their taste and preferences for spices. Cooking fat and ingredients were provided along with recommended meal preparation guide.

Prudent Diet
  • This diet is based on the DASH (Dietary Approaches to Stop Hypertension) diet
  • Low saturated fat by including plant proteins, lean animal protein, dairy fats.
  • High in fruits and vegetables, whole grains, poultry, nuts and vegetable oils.
  • Low on processed food.
  • 6 cups of vegetables and fruits were provided to the study participant every day
  • The diet provided 40g of fiber per 2000 kcal from vegetables, fruits, nut and whole grains.
Western Diet
  • This diet included a lot of processed meat, high-fat dairy products, eggs, red meat
  • Hash browns and french fries
  • High sugar drinks and sweets
  • Less than 3 cups of vegetables and fruits were provided, mostly in the form of juices
  • The diet provided less than 14g of fiber per 2000 Kcal.
Both the diets were considered to be palatable to the study participants. The period of study was selected to be 2 weeks to understand the initial effects of these nutritional interventions.

The results of the study showed that there was a slight lowering of the risk for cardiovascular disease along with small changes to the body composition for those participants following the prudent diet. This shows that epigenetic factors play a role in cardiovascular health.

A leading cardiologist from Chennai, Dr Parthasarathy Harikrishnan had this to say about the study and the benefits of eating a diet rich in fruits and vegetables " This is a very good study proving once again that modifying our lifestyle in the form of PRUDENT DIET, lowers traditional cardiovascular risk factors in the form of reduced blood pressure and reduced bad cholesterol levels. This once again underlines the fact that " WE DO NOT NEED TO DIET BUT SHOULD EAT RIGHT"."

Dr. Parthasarathy Harikrishnan

Dr Harikrishnan believes that the PRUDENT diet is a good diet and that "The PRUDENT DIET with high fruit and veg content with low saturated fat content should be followed from childhood and adults should set an example to children. This study underlines this concept and proves that this is true even in those with high cardiovascular risk in the form of genetic polymorphism at 9p21."

Commenting on the Indian scenario, Dr Harikrishnan feels "In the Indian concept we should avoid blindly copying the Western diet and eat healthy Indian food along with plenty of fruits and vegetables. Plenty of exercises should be undertaken and incorporated as part of our day to day routine."

References :
  1. Riyaz S. Patel, Folkert W. Asselbergs, Arshed A. Quyyumi, Tom M. Palmer, Chris I. Finan, Vinicius Tragante,,§ John Deanfield, Harry Hemingway,Aroon D. Hingorani, and Michael V. Holmes "Genetic Variants at Chromosome 9p21 and Risk of First Versus Subsequent Coronary Heart Disease Events"; J Am Coll Cardiol. 2014 Jun 3
  2. George Hindy, Ulrika Ericson, Viktor Hamrefors, Isabel Drake, Elisabet Wirfält, Olle Melander, and Marju Orho-Melander "The chromosome 9p21 variant interacts with vegetable and wine intake to influence the risk of cardiovascular disease: a population based cohort study" BMC Med Genet. 2014
  3. Michael A. Zulyniak, Russell J. de Souza, Andrew Mente, Sujane Kandasamy, Monisha Nundy, Dipika Desai, Kripa Raman, Ranya Hasso, Guillaume Pare, Joseph Beyene and Sonia S. Anand "A randomized controlled trial of the effects of a prudent diet on cardiovascular risk factors, gene expression, and DNA methylation - the Diet and Genetic Intervention (DIGEST) Pilot study" BMC Nutrition, 18th March 2016
Source: Medindia

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