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Aspirin therapy may not lower heart attack risk for those with type 2 diabetes

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

Add color to your diet for good nutrition

Vegetable-rich diets are associated with lower risk for chronic disease. To get the full range of nutrition from plant foods, choose from a variety of colors when you shop and eat, including blue/purple, green, orange/yellow, white/light green, and red.

How to stay in the sodium safe zone

Excessive sodium raises blood pressure, which raises cardiovascular risks. Reading nutrition labels, considering sodium in restaurant meals, getting adequate potassium, and reducing calorie consumption can lower dietary sodium intake.

Prescription bargain hunt

Here's how to get a better deal on your medication.


Image: © Habman_18/Thinkstock

You're not alone if you've ever skipped filling a prescription because it was expensive. Cost is one barrier to keeping people on their medication regimens. "It's a real problem. Medications only work if people take them, and you can't take them if you can't afford them," says Dr. Joshua Gagne, a pharmacist and epidemiologist with Harvard-affiliated Brigham and Women's Hospital.

According to a National Center for Health Statistics survey, about 8% of adults in the United States don't take prescribed medications because they can't afford them.

Should I try a new blood thinner?

Ask the doctor


 Image: © bowdenimages/Thinkstock

Q. I've been taking the blood thinner warfarin (Coumadin) for a few years. I know there are new kinds of blood thinners, but I've heard they have downsides. Should I stick with warfarin?

A. Here's what you need to know. Some medical conditions lead to blood clots. The most common one is the irregular heart rhythm called atrial fibrillation. About 20% of all strokes are caused by clots that result from atrial fibrillation — usually because of inadequate treatment with blood thinners.

Power up your diet with plant-based meals

Opting for more vegetables and plant-based proteins is a new trend that's long been healthy.


 Image: © Derkien/Thinkstock

Plant-based meals aren't just for vegetarians anymore. International food consultants Baum and Whiteman named vegetables and plant-based proteins two of the hottest restaurant trends for 2017. That's no surprise to Harvard dietitians. "There are many reasons why people are eating more plant-based meals," says registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. "Part of it is about health, and part of it is about eating more environmentally sustainable meals."

Veg-centric meals

One of the trends is the "vegetable forward" or "veg-centric" movement. It's taken average vegetables and elevated them into creative entrées and side dishes. This cuisine focuses on roasting, layering, caramelizing, and grilling vegetables to give them bold flavors and appeal. You might find restaurants offering caramelized cauliflower with balsamic breadcrumbs, roasted parsnips with pistachio and lemon, or bitter greens and crispy yams. In some cases, the dishes are accompanied by chunks of animal protein (meat, poultry, or fish) that complement the meal but don't dominate it, similar to a Mediterranean-style diet.

Study ties Mediterranean diet to larger brain volume

News briefs


 Image: © Francisco Arara/Thinkstock

Can eating a Mediterranean diet help you hold on to more brain cells in older age? A study published online Jan. 4, 2017, by Neurology suggests there's an association. Scientists measured the brain volumes of about 400 dementia-free people, taken when participants were age 73 and again at age 76. Researchers then compared the changes in brain volume over the three years to questionnaire answers about how well participants stuck to a Mediterranean-style diet. The diet includes lots of fruits, vegetables, olive oil, legumes, and whole grains; moderate amounts of fish, dairy foods, and red wine; and limited amounts of red meat and poultry.

Sticking to the diet was associated with a lower amount of total brain shrinkage over the three-year study period. The finding is only observational and doesn't prove that eating a Mediterranean diet slows age-related brain shrinkage. But other studies have linked eating a Mediterranean diet to larger brain volumes. The diet is also associated with better thinking skills, a reduced risk of Parkinson's disease and Alzheimer's disease, and a reduced risk of dying from heart disease or cancer.

Cracking the coconut craze

Are oils and other products made from this tropical fruit a healthy choice?


 Image: © Magone/Thinkstock

Recently, a Harvard Heart Letter reader emailed us a question about coconut oil, a solid white fat that's been touted as a health food, specifically for the heart. Lately, more coconut-based products, including spreads and beverages, are showing up on grocery store shelves, along with jars of coconut oil. But this reader isn't buying it. "I cannot imagine that a food with so much saturated fat could be healthful. What is the latest scientific information regarding coconut oil?" he wrote.

Extracted from white "meat" inside the brown, hard-shelled fruit of the coconut palm, coconut oil is indeed chock-full of saturated fat. In fact, it's about 90% saturated fat, a much higher proportion than butter (64%) or lard (40%). Too much saturated fat in the diet raises harmful LDL cholesterol, which increases the risk of heart disease. But what else do we know about the health effects of this tropical fruit?

Nordic diet linked to lower stroke risk

Research we're watching

Following a Nordic diet — which features fish, whole grains, plus fruits and vegetables popular in Scandinavian countries — may help lower the risk of stroke, a new study suggests.

The study, published in the February 2017 issue of Stroke, included more than 55,000 Danish people from a national health registry, all of whom filled out questionnaires about their diets and other lifestyle habits. Researchers looked at how closely the participants followed the Healthy Nordic Food Index, which includes six food categories: fish, apples and pears, root vegetables (such as carrots and celery root), cabbages (which also include broccoli, cauliflower, kale, and Brussels sprouts), rye bread, and oatmeal.

Supplements used as statin alternatives pose safety issues

Research we're watching

Dietary supplements made from red yeast rice contain substances called monacolins, which are similar to the active ingredient in cholesterol-lowering statin drugs. And like statins, red yeast rice products may cause rare but serious side effects, such as muscle injury and liver damage, as noted in a study published online January 19, 2017, by the British Journal of Pharmacology.

The study, based on a review of 13 years of patient data by Italian researchers, notes that people who can't tolerate statins often take red yeast rice supplements. But there are no studies testing the safety of red yeast rice compared with statins. In the United States, the FDA considers red yeast rice products that contain more than trace amounts of monacolins to be unapproved new drugs and therefore illegal to sell. Yet dozens of these unregulated products remain on the market.

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