Cardiology: Diets which curb rapid release of sugar into the bloodstream can play a critical role in combating inflammation in the walls of arteries, and thereby prevent heart disease.
Europe's leading cardiologists have been told foods such as potatoes, certain kinds of white bread and rice - which trigger a quick release of sugar into the blood - are now being targeted as the chief cause of arterial wall inflammation.
Doctors attending the International Congress on Lipid Metabolism in Venice heard that inflammation was the main culprit in the formation of plaques in blood vessels.
Prof Rodolfo Paoletti, president of the Giovanni Lorenzo Foundation, said inflammation could be detected by measuring levels of "C reactive protein" (CRP) in the blood.
A diet of fruit, vegetables and fish helps combat this inflammation, Dr Andrea Poli, scientific secretary of the Italian Heart Foundation, said. Asked about the possible negative effects of pasta, she said: "It is absolved, provided it is Italian and cooked al dente."
Researchers from Canada outlined the benefits of a "portfolio diet", a combination of plant foods with known cholesterol-lowering properties. Dr David Jenkins and his colleagues from the University of Toronto recommended the use of soy protein, plant sterols and nuts as a method of reducing cardiovascular disease. "Individually they are recognised as lowering blood cholesterol by 4 to 7 per cent. In combination, an average 13 per cent reduction in LDL [ bad] cholesterol can be sustained over a six-month period," he said.
Experts warned that a condition called metabolic syndrome now affects 20 per cent of the population in the West, so much so that it has become "a major public health issue". The syndrome is characterised by the presence of at least three of the following risk factors: high blood sugar, high cholesterol, a large waist circumference, high blood pressure and a low level of HDL (good) cholesterol.
"Metabolic syndrome patients tend to have higher inflammation indicators such as CRP," Prof Alberico Catapano of the University of Milan told the meeting. "We know that adjusting nutrition and increasing physical exercise reduces cardiovascular risk in metabolic syndrome patients."
The conference also heard about new developments in drug therapy. Apart from statins, which lower LDL (bad) cholesterol, new agents which increase HDL (good) cholesterol levels are being developed. These drugs work directly on the vessel walls and actually "clean" the arteries.
Agents such as apolipoprotein A-1 Milano mimic the action of HDL, by transporting excess bad cholesterol from arterial plaques to the liver, where it is excreted from the body. However, A-1M is expensive and can only be administered intravenously. The new drugs could work in combination with statins, established cholesterol-lowering medication, Prof Paoletti said. "Statins are extremely important; they have significantly reduced cardiovascular risk in patients."
Noting that the absolute benefits of statin treatment depend on a person's overall risk of a major vascular event, Dr Rory Collins of the Department of Clinical Medicine at Oxford University said statin therapy should be considered for all patients at high risk, "irrespective of their initial cholesterol levels, age or sex".
Dr Michael Conway, consultant cardiologist and Mr Ciaran Reid, research fellow at St Luke's Hospital Kilkenny, presented research into a method of detecting vascular disease called "pulse wave velocity". Using a non-invasive technique to measure pulse velocity in the arm, they have discovered a link between pulse velocity and the presence of stiffness in the arteries. "Our discovery has the potential to become an early indicator of heart and arterial disease," said Dr Conway.