Health: A Cereal That's Good for the Heart

For the last several years, Chicago attorney Karl Anderson, 52, has been eating high-fiber, low-sugar oatmeal and raisin-bran for breakfast, often with a banana. Sure, he's tempted by the coffee cake and pastries on his kitchen counter. And he fondly remembers loving Cap'n Crunch and Cocoa Krispies as a kid. "But I know those aren't good for you," he says.

Today, Anderson feels better than ever better about his choice. That's because a Harvard study of 21,376 male physicians, published this week in the Archives of Internal Medicine, found that men who eat whole-grain cereal have a lower incidence of heart failure than men who don't. "I'm happy to hear it," says Anderson. (The whole-grain study is part of the ongoing Physcians' Health Study.)

Though past studies have found an association between whole-grain cereal consumption and a lower risk of heart disease and high blood pressure, this is the first major study of whole-grain cereal consumption and congestive heart failure. (In CHF patients, the heart cannot pump enough blood to the body's other organs.) Researchers saw a 28 percent decrease in the risk of developing heart failure in men who ate whole-grain cereal at least seven times a week, and a 22 percent decrease in men who ate it two to six times per week. The National Institutes of Health, not cereal makers, funded the study.

The study is good news because it's so easy to eat whole-grain cereal. "This is something everybody can do," says dietitian Linda Van Horn, a nutrition researcher and professor of preventive medicine at Northwestern University. "This is a practical, low-tech kind of response to a public health problem that is huge and takes a major toll on American lives. It is especially important because it demonstrates that indeed, diet really does make a difference."

"It's another feather in the cap of whole grains," says New York dietitian Milton Stokes, a spokesman for the American Dietetic Association. He cautions that the study is "not conclusive" since it simply looked at associations based on participant-reported dietary intakes. But he also says no one can go wrong with choosing whole grains over processed foods.

Just why does whole-grain cereal seem to reduce the risk of heart failure? The best bet: its high fiber and potassium content, says Dr. Luc Djousse, lead author of the study and an epidemiologist at Harvard Medical School and Brigham and Women's Hospital. Potassium lowers blood pressure, one of the major risk factors for heart failure.  "We think it works along these lines—that a combination of fiber, potassium and other minerals would lower your blood pressure and improve insulin utilization by the body, and thereby prevent obesity and heart disease," says Djousse. "All these mechanisms are contributing to a lower risk of heart failure." Though the study looked at men, Djousse believes the results would hold true for women, too.

Of course, eating whole-grain breakfast cereal alone is not a panacea. "There's no single intervention that will resolve all the problems," says Djousse. For a healthy heart, it's also important to work out, shun cigarettes and avoid drinking more than two alcoholic beverages a day (for men) or more than one alcoholic beverage a day (for women). "We have to consider total lifestyle. Don't smoke, exercise regularly, make sure you get a physician's checkup. If you have high blood pressure, control it. And eat a well-balanced diet of fruits, vegetables and the right kind of protein," says Stokes.

And as always, buyer beware. Djousse recommends looking for cereal that contains 4 or more grams per serving-rather than just looking for the words "whole grain." (Though he didn't specifically study whether it's good to add some cut-up fresh fruit, he thinks it's a nice idea--especially if it keeps someone from adding sugar for extra sweetness.)

It's important to read the fine print on labels, experts say. "I would caution people that the words 'made with whole grain' could mean a fleck of whole grain. It could be made mostly with white flour," says Bonnie Liebman, nutrition director of the Center for Science in the Public Interest." "Look for a label that says '100 percent whole grain,' or read the ingredients and make sure the ingredient list says 'whole grain wheat,' 'whole grain corn.'" Some companies are adding refined fibers, including cellulose, which may not convey the same benefits. "It's never going to say 'cellulose,'" says Liebman. "It will say things like 'wheat fiber.'" (In the United States, foods considered "whole grain" officially contain at least 51 percent of whole-grain ingredients per serving.)

Don't get carried away, either. Stick to a half-cup to a cup of cereal. "It's easy to go beyond what a serving is," says Liebman. Sadly, a serving is often the size of a tennis ball-or less. If people overdo, they'll gain weight. "You're going to offset the benefits," says Djousse. "The key thing is portion size." Djousse eats oat or bran cereal for breakfast. and he always avoids refined sugar, which raises insulin levels "and makes you hungry within an hour," he says. If he's in a rush, he may just eat an apple. But he notes that whole-grain cereal, unlike fruit, also contains healthy polyunsaturated fat. He also skips juice since it's high in sugar. And he bypasses bacon, which is high in saturated fat.