Should You Live PURE?

iStock-157614058Fat has been excoriated in the diet world for decades, but now a study known by the acronym PURE has challenged conventional wisdom, Rick and I discuss on PodMed this week. The study was published in the Lancet and presented at the European Society of Cardiology meeting, and caused me to ask "should you live PURE?" Here's what you need to know to answer that question:

The acronym PURE stands for Prospective Urban Rural Epidemiology study, and it was conducted in over 130,000 low and middle income participants in 18 countries between 2003 and 2013, with a median follow up of 7.4 years. Using that favorite tool, the validated food frequency questionnaire, researchers carefully assessed specific nutrient intake and correlated that with total mortality and major cardiovascular events. Correlations were calculated based on carbohydrate, total fat, saturated fat, polyunsaturated fat and monounsaturated fat. In short, the study found that high carbohydrate intake was associated with greater risk of mortality, while fat of any type was associated with a lower risk. Neither total fat nor types of fat were associated with cardiovascular disease, heart attacks or death from heart disease, and most interestingly, there was an inverse relationship of fat consumption and stroke. Well.  Flies in the face of years of previous research, no? As Rick and I discuss in the podcast, there is no assessment of exercise or daily activity, often higher in those of low and middle income, nor is there data on BMI. One question that arises is is higher fat consumption in those of lower BMI and higher daily activity advantageous?

Other studies this all-heart week include two from NEJM:Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease and Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation, and in Annals of Internal Medicine: Accuracy of Cardiovascular Risk Prediction Varies by Neighborhood Socioeconomic Status. Until next week, y'all live well.

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