Issue link: http://viewer.e-digitaledition.com/i/938319
A NUTRITIONAL APPROACH TO Reducing Peripheral Artery Disease BY K AITLIN GUNTER Barriers to Good Nutrition While people may view expense as a key barrier to fruit and vegetable intake, a 2016 study published in the Journal of Public Health found that perceiving food as boring or unappetizing was a more significant impediment. THREE FRUIT AND VEGE TABLE SERVINGS PER DAY MAY REDUCE RISK FOR DE VELOPING PERIPHER AL ARTERY DISE A SE PAD. THAT WA S A KE Y FINDING OF AN ANALYSIS THAT RE VIE WED DATA ON 3.7 MILLION PEOPLE AND APPE ARED RECENTLY IN ARTERIOSCLEROSIS, THROMBOSIS, AND VASCULAR BIOLOGY. A T Y PE OF atherosclerotic disease in which plaque buildup results, typically, in blocked leg arteries, PAD can cause leg pain with physical exertion and may lead to tissue death when left untreated. Limited research on the potential of dietary approaches to reduce PAD led NYU Langone Health cardiologists and Medicine Faculty Sean P. He ron, MD, MS, MSc, and Je rey S. Berger, MD, MS, to ana lyze data from dietar y sur veys and vascular screening examinations — primarily diagnostic tests for PAD — at over 20,000 U.S. sites in connection with Life Line Screening. Researchers con- trolled for more than a dozen established risk factors for atherosclerotic disease in their investigation of an association of fruit and vegetable consumption with prevalent PAD. SILVER LINING FOR SMOKERS? Results showed an 18 percent reduction in risk for having PAD among people who reported eating three or more servings of fruits and vegetables daily, as compared with those who least frequently consumed fr uits a nd vegetables. W hen looking specif ica lly at those who derived the greatest benefit from fruit and vegetable intake, current and former smokers who frequently ate fruits and vegetables had the greatest reduction in odds of having PAD. This makes sense on a biological level. Smokers are already at high risk of developing PA D because smoking damages heart and blood cell function, according to the National Heart, Lung, and Blood Institute. Smoking introduces very high levels of reactive oxygen species, an important mechanism in initiating atherosclerotic disea se, into t he body, according to Dr. He ron. Eating fruits and vegetables, on the other hand, provides the body anti- oxidant nutrients, vitamins in particular. "Those who have high reactive oxygen species but also high levels of antioxidants from fruits and vegetables might stand to most benefit and be protected [from PAD] due to their fruit and vegetable consump- tion," Dr. He ron says. ENGAGING THE DISENGAGED Approximately 30 percent of sur vey pa r ticipa nts repor ted eating at lea st three ser vings of fruits a nd vegetables da ily. The World Hea lth Orga nization recommends f ive ser vings per day for a hea lthy diet. While many people know they should eat fruits and vegetables, there is clearly a disconnect when it comes to acting on this information, Dr. He ron says, and that's where physician recommendations and more nutritiona l counseling and public health initiatives come into play. According to Dr. He ron, the most important research in the future includes studies to determine the ešcacy of hiring dietitians for physicians' ošces and of using dietary questionnaires to motivate behavioral change. Other interventions include influencing public policy in order to provide fruit and vegetable carts in food deserts in poor neighborhoods. ■ SPECIAL CLINICAL SECTION: CARDIOLOGY 2 4