Role of Cardioprotective Diet in Acute Coronary Syndrome

Problem statement: Nutritional factors appear to be quite important in the pathogenesis and prognosis among patients of Acute Myocardial Infarction (AMI) or Acute Coronary Syndrome (ACS). Increased consumption of proinflammatory foods; such as refined starches and sugar, trans fat, saturated fat and w-6 fatty acids may increase proinflammatory cytokines, oxidative stress and free fatty acids causing endothelial dysfunction. Approach: Columbus foods with low w-6/w-3 ratio of fatty acids, may play a protective role. Many adverse parameters such as higher concentrations of proinflammatory cytokines, transcription factors and adhesion molecules, free radicals and decrease in nitrite levels were shown to be related to the dietary composition and thus may serve as independent predictors of ACS. Diets rich in w-3 fatty acids, vitamins, minerals and antioxidants and low in refined carbohydrates cause decrease in levels of plasma lipid peroxides, antioxidant vitamins, serum Glutamic Oxaloacetate Transaminase (SGOT) and Lactate Dehydrogenase (LDH) cardiac enzymes in patients with ACS. Results: Available evidence indicate that cardioprotective diet can decrease sudden cardiac deaths, total cardiac deaths, non-fatal infractions and total cardiac events among patients receiving such diet compared to standard diet. The existing evidence support that diet rich in w-3 fatty acids, vitamins, minerals and antioxidants with low refined carbohydrates may be beneficial to vascular endothelium and myocardium and thus seems to function as cardioprotective in patients with ACS. Conclusion: The Western foods that lack essential vitamins, minerals and w-3 fatty acids and that are rapidly absorbed should be avoided in patients with ACS. More studies especially in the context of developing countries are required for establishing the vital role of the cardio protective diet.