More American men die from heart disease than from any other cause. In fact, one in three men can expect to develop some major cardiovascular disease (CVD) before the age of 60. But, men aren’t the only ones affected. CVD affects more women than men and is responsible for more than 40% of all deaths in American women.

CVD is an umbrella term for a constellation of diseases, including coronary artery disease , congestive heart failure , high blood pressure , and stroke . Almost one million Americans die from CVD every year. In addition, the cost of CVD in 2004 is estimated to be $368.4 billion.

Researchers are continually looking for new and inventive ways to lower the risk of CVD. Given our love for medications in this country, it’s not surprising that a 2003 study evaluated the effects of the so-called “Polypill,” which combined six different medications: aspirin, folic acid, a cholesterol-lowering drug, and three drugs to lower blood pressure at half the normal dose. The authors suggested that if the Polypill was given to everyone 55 and older, it would prevent 88% of heart attacks and 80% of strokes. Some have questioned the wisdom of this approach, however, given the well-known risks associated with long-term drug use.

Now, in a study published in the December 18-25, 2004 issue of the British Medical Journal , researchers report on the cardiovascular effects of a so-called “Polymeal” consisting of certain heart-healthy foods or ingredients consumed on a daily basis.

About the Study

The study looked at published clinical trials to determine which ingredients to include in the Polymeal. In order to be included, an individual ingredient had to show a reduction in CVD events (e.g. heart attacks) or a modification of risk factors for CVD.

The following table lists the ingredients that met these criteria. The second column lists the amounts that appeared to produce a reduction in risk of CVD, which is the percentage in the third column. The final column is intended to provide a measurement equivalent more helpful than grams.


Study Measurement

% Reduction in Risk of CVD



150 militers (mL)/day


5 ounces (oz) wine = 150 grams (g)


114 g four times/week


3 oz salmon = 85 g

Dark chocolate

100 g/day


1 oz = 28 g

Fruit and vegetables

400 g/day


1 apple = 150 g

1 pepper = 74 g


2.7 g/day


1 garlic clove = 2.7 g


68 g/day


1 oz almonds= 28 g

All ingredients taken together are considered the Polymeal diet. In order to see how much benefit the general population might gain from consuming the Polymeal, the researchers applied the combined effect of the ingredients to subjects already participating in a large observational trial, the Framingham Heart Study. They were interested in seeing to what extent the Polymeal would modify these endpoints:

  • Non-fatal CVD, including angina, heart attack, stroke, and poor circulation to the legs
  • Fatal CVD
  • Other causes of death

The Findings

Based on calculations using mathematical models, the authors concluded that combining all the ingredients of the Polymeal would have reduced CVD risk by 76%, and would have prolonged life expectancy by 6.6 years for men and 4.8 years for women.

And unlike medications, the adverse effects attributed to these ingredients are minimal. Garlic could cause an increase body odor, flatulence, esophageal and abdominal pain, allergic reactions, and bleeding. Fish consumed in larger amounts than what the study recommended could theoretically lead to higher levels of mercury in the blood, particularly the larger fish such as swordfish and shark.

How Does This Affect You?

These findings are quite provocative: can diet alone really have this kind of impact on CVD risk? Many studies have demonstrated the effect of diet on cardiovascular health. But, this study does have limitations. It was not conducted in people, meaning men and women were not fed this diet and then compared to a group who ate a regular diet. Conducting a randomized controlled trial (the gold standard of clinical trials) in which the Polymeal was compared to a regular diet, would make these results far more convincing.

Does this mean the study’s results should be disregarded? Not exactly. Abandoning your current diet and consuming only those items in the Polymeal does not make sense at this point. It is certainly reasonable, however, to substitute foods known to increase CVD risk—such as saturated fats—with all or some of the Polymeal foods. Also, diet alone is insufficient to minimize risk. Regular exercise and periodic screening tests have also been shown to delay the ill effects of CVD.

Finally, although several studies have shown alcohol to have a positive effect on heart health, there is insufficient evidence to encourage non-drinkers to begin drinking. If you do consume wine, one glass for women and 1-2 glasses for men is the recommended amount.