Lifestyle changes to reduce CARDIOvascular risks

Lifestyle changes can make big differences in cardiovascular (CV) risk and overall health. Improving nutrition, reducing sodium intake, avoiding smoking, increasing physical activity, and getting to a healthy weight make up the backbone of lifestyle changes, either alone or in combination with cholesterol-lowering medications (Statins, etc). The following points provides a summary of the newest recommendations for lifestyle changes that can help patients reduce their CV risk...

          DIET consistent with the DASH (Dietary Approaches to Stop Hypertension) or Mediterranean diet works best to lower cardiac risk. Have patients aim for more fruits and veggies, low-fat dairy, whole grains, poultry, and fish and less red meat, sweets, and sugary drinks. Advise patients not to get too hung up on restricting total fats. Recommend limiting saturated fats to ≤ 6% of calories and avoiding trans fats. Recommend healthier oils, canola, olive, etc.

SODIUM (salt) should be limited to ≤ 2400 mg/day for most patients and possibly lowered to 1500 mg/day for patients with hypertension. Explain that reducing sodium by 1000 mg/day or about half a teaspoon of salt can modestly lower blood pressure. Suggest cutting back on processed foods. Explain that there's about 1000 mg of sodium in some cans of soup or 2 slices of cheese pizza. 

WEIGHT LOSS of just 5% can lower blood pressure, lipids, and blood glucose. Advise cutting 500 or more cal/day to about 1200 to 1500 in women and 1500 to 1800 in men. Suggest using a food diary or app to keep track. Save weight loss drugs for when lifestyle changes alone aren't enough for patients with a BMI ≥ 30 or ≥ 27 with a weight-related condition such as diabetes or hypertension.

REFERENCES

  • Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr, Tomaselli GF; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014 Jun 24;129(25 Suppl 2):S102-38. Available at: https://pubmed.ncbi.nlm.nih.gov/24222017

    Eckel, R.H., Jakicic, J.M., Ard, J.D., de Jesus, J.M., Miller, N.H., Hubbard, V.S., Lee, I-Min., Lichtenstein, A.H., Loria, C.M., Millen, B.E., Nonas, C.A., Sacks, F.M., Smith, S.C., Svetkey, L.P., Wadden, T.A. and Yanovski, S.Z. (2013). 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. Circulation, 129(25 suppl 2), pp.S76–S99. Available at: https://www.ahajournals.org/doi/full/10.1161/01.cir.0000437740.48606.d1

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