The fried foods, salty snacks and meats that are staples of the Western diet account for about 30 percent of heart attack risk across the world, a new report suggests.

Meanwhile, a diet rich in fruits and vegetables, the so-called "Prudent" diet, is tied a low risk of heart attack, according to the study, published in the Oct. 21 issue of Circulation.

The research, which looked at dietary habits in 52 countries, found people who ate a Western diet had a 35 percent greater risk of having a heart attack compared to those who ate little or no fried foods and meat. Those who followed a "Prudent" diet had a 30 percent lower risk of heart attack compared to those who went light on fruits and vegetables.

The authors also looked at an "Oriental" diet, rich in tofu, soy and other sauces, and found it did not increase or decrease the risk of a heart attack.

Previous studies have reached similar conclusions about the "Prudent" and Western diet in the United States and Europe, but did not include the Oriental pattern of eating. While some components of the Oriental diet may protect against heart trouble, the higher sodium content of sauces counter that benefit.

"This study indicates that the same relationships that are observed in Western countries exist in different regions of the world," study senior author Salim Yusuf, a professor of medicine at McMaster University and director of the Population Health Research Institute at Hamilton Health Sciences in Ontario, said in an American Heart Association news release.

The Canadian researchers analyzed risk factors in food choices and the risk of heart attack in about 16,000 people in 52 countries. Almost 6,000 people had heart attacks, while the rest had no known heart disease.>>>>

Western Diet Is a Global Heart Risk

The INTERHEART study, funded by the Canadian Institutes of Health Research, shows that the risk of heart attack crosses geographic boundaries and correlates strongly to the so-called Western diet that favors salty snacks and fried foods, and to a lesser extent, meat.

The risk, spread over five continents, is 30% higher for those who eat a Western diet, the study shows, than for those who adhere to a "prudent diet," or one rich in fruits and vegetables. An Oriental diet, which is high in tofu and other soy products, doesn't seem to lower or raise heart attack risk overall, according to the study.

Researchers out of McMaster University in Ontario, Canada, examined dietary trends among more than 16,000 participants in 52 countries who were recruited between 1999 and 2003. One-third of the participants, or 5,761 people, were interviewed after having a single heart attack; the remaining 10,646 had no known heart disease, including angina, and did not suffer from diabetes, hypertension, or high cholesterol. The mean age of participants was between 53 and 57 years old.

The study categorized eating patterns as Western, Oriental, and prudent. Participants answered written questions and were interviewed by medical personnel about their consumption of 19 food categories, including leafy greens, pickled foods, dairy products, and desserts. All answers were scored according to dietary risk.

The study accounted for other risk factors like smoking, body mass index, age, physical activity, sex, and geographical region in assessing overall heart attack risk. It did not track long-term changes in regional eating habits and their link with health problems.

Researchers concluded that the higher the regular intake of fried and salty foods, the higher the risk of heart attack regardless of which region of the world one resides in; prudent dietary habits carried the lowest risk. An Oriental diet seemed to be protective against heart attack in some regions of the world, but was not the best hedge overall, perhaps because of the high salt content of soy and other sauces common in the dining choices.

"The objective of this study was to understand the modifiable risk factors of heart attacks at a global level," says Salim Yusuf, DPhil, the study's senior author. "This study indicates that the same relationships that are observed in Western countries exist in different regions of the world."

Yusuf is a professor of medicine at McMaster University and is director of the Population Health Research Institute at Hamilton Health Sciences in Ontario, Canada.

The study acknowledges that serving sizes and preparation technique (the type of fat used in cooking, for example) could play a role in increasing heart attack risk in participants adhering to a Western diet.