After a heart attack, adopting either a low-fat or Mediterranean-style diet significantly benefits overall and cardiovascular health, research suggests.

The diets provide similar amounts of protein, carbohydrates, cholesterol and unhealthy saturated fats, but a Mediterranean diet has higher amounts of "healthy" monounsaturated fats, particularly omega-3 fatty acids found in fish.

Either diet, when applied with equal intensity, can be an effective component of post-heart-attack lifestyle changes, researchers say. Post-heart-attack patients who followed these diets for four years significantly reduced their risk for subsequent cardiovascular events, Dr. Katherine R. Tuttle and colleagues found. Compared with first heart attack patients receiving usual care, the risk for subsequent death or cardiovascular events, "was about 70 percent lower in dietary intervention participants," Tuttle told Reuters Health. The findings are published in The American Journal of Cardiology.

Tuttle, of Sacred Heart Medical Center and the University of Washington School of Medicine in Spokane, Wash., and colleagues recruited 50 patients to actively follow the American Heart Association Step II diet (low-fat) and 51 to follow a Mediterranean-style diet. The men and women, who had suffered their first heart attack within six weeks of enrolling in the study, received individual and group dietary counseling for up to 24 months. They were also encouraged to exercise, lose weight and stop smoking, if needed.

After four years, the researchers found that eight individuals in each dietary intervention group had either a second heart attack, unstable angina (chest pain on exertion) or stroke. None had died.

When Tuttle's team assessed a similar group of 101 first-heart-attack patients who did not participate in the study but received usual care, they found 33 with subsequent heart attack, heart failure, unstable angina or stroke, and seven deaths (three heart-related).

These findings, though from a modestly sized study population, reflect "real-world" experience as participants bought and prepared their own foods, the researchers note.

Active participation in either a low-fat or a Mediterranean-style diet can be "prudent choices" in those at high-risk for cardiovascular events, Tuttle and colleagues conclude.

SOURCE: The American Journal of Cardiology, June 2008 and Reuters Health.

QUESTION AND ANSWER

Q: Is there any research to support claims that chromium supplements may aid weight loss?

A: Chromium, an essential mineral found in meats, whole-grain products and some fruits and vegetables, has received lots of attention from weight-loss researchers thanks to its apparent role in carbohydrate, fat and protein metabolism. But for several years the research has failed to show a weight control benefit from taking chromium supplements, despite claims that it can enhance fat loss and help build lean muscle. Two recent trials in which chromium supplements were compared against inactive (placebo) pills again showed no weight loss benefit among those getting extra chromium.

And while some studies show small benefits in blood sugar control for people with diabetes, the benefits are inconsistent and do not seem related to weight control. While chromium itself may not increase weight loss, choosing chromium-rich foods like whole grains and broccoli, will provide additional dietary fiber — a strategy that has been shown to help with weight control. — American Institute for Cancer Research.

RAISING THE BAR

Food manufacturers that want to add the American Heart Association's heart check mark on their products must now meet a new trans-fat criterion. Today all products bearing the check mark must have less than .5 grams of trans fat per reference amount customarily consumed and per labeled serving size. The heart check mark lets consumers know that certain food items are certified to be low in total fat, saturated fat, trans fat and cholesterol. For more information, go to www. heartcheckmark.org. — Today's Diet & Nutrition.

WINNING RECIPE

This recipe for Honey Cracked-Wheat Bread fits in with a low-fat lifestyle. It's from "Low Fat Living" by Robert Cooper.

HONEY CRACKED-WHEAT BREAD

2 cups warm water

2 tablespoons active dry yeast

4 1/2 to 5 1/2 cups whole-wheat flour

1 cup cracked wheat

1/2 cup oat bran or wheat bran

1/3 cup sesame seeds

1/3 cup honey

2 tablespoons molasses

1 tablespoon canola oil

2 teaspoons salt

Yields 2 loaves (24 slices).

Pour water in a large bowl and sprinkle yeast on top. Set aside to proof for 5 to 10 minutes.

Stir in 2 cups flour. Beat for 3 minutes with electric mixer. Stir in cracked wheat, bran, sesame seeds, honey, molasses, oil and salt.

Turn out on a floured counter and knead in enough of the remaining flour to form a workable dough. Knead for 10 minutes or until smooth and elastic. Form into a ball. Lightly coat a large bowl with a little oil. Add dough and turn ball to coat. Cover bowl and set aside in a warm place, allowing dough to rise for 1 hour.

Lightly oil two 9x5-inch pans or coat them with no-stick cooking spray. Punch dough down and divide in half. Shape into a loaf and place in prepared pans. Cover and let rise in warm place 30 minutes.

Preheat oven to 350 F. Bake for 30 to 45 minutes or until done. Remove bread from pans and cool on wire rack. Makes 2 loaves; 24 slices.

Per slice: 136 calories, 4.9 g protein, 26.5 g carbohydrate, 2.3 g fat, no cholesterol, 3.4 g dietary fiber, 182 mg sodium.

Charlyn Fargo is a registered dietitian in Springfield, Ill. For questions or comments, you can contact her at charfarg@aol.com. To find out more about To find out more about Charlyn Fargo and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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